Healthcare Provider Details

I. General information

NPI: 1235989526
Provider Name (Legal Business Name): MICHAELINE MARY ONDREY RN, NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

683 STINSON BLVD
SAINT PAUL MN
55112-2511
US

IV. Provider business mailing address

683 STINSON BLVD
SAINT PAUL MN
55112-2511
US

V. Phone/Fax

Practice location:
  • Phone: 612-210-9897
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2271756
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number2271756
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number2271756
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3888831
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: