Healthcare Provider Details

I. General information

NPI: 1760603419
Provider Name (Legal Business Name): JOANNE BARBARA MICHALEK APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHILDREN'S HOSPITAL 300 LONGWOOD AVE
BOSTON MA
02115
US

IV. Provider business mailing address

17 BRADFORD AVE
SHARON MA
02067
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-4750
  • Fax:
Mailing address:
  • Phone: 781-784-9548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number103406
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number103406
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: