Healthcare Provider Details

I. General information

NPI: 1740338409
Provider Name (Legal Business Name): MICHELLE HANNAH GUREL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

0 EMERSON PL SUITE 112
BOSTON MA
02114-2241
US

IV. Provider business mailing address

51 MALCOLM RD
JAMAICA PLAIN MA
02130-3439
US

V. Phone/Fax

Practice location:
  • Phone: 617-724-0145
  • Fax:
Mailing address:
  • Phone: 617-395-8360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number225440
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: