Healthcare Provider Details

I. General information

NPI: 1699447979
Provider Name (Legal Business Name): MICHELLE HOHL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2021
Last Update Date: 10/04/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6616 LINCOLN AVE
LOCKPORT NY
14094-6109
US

IV. Provider business mailing address

6806 BEAR RIDGE RD
LOCKPORT NY
14094-9215
US

V. Phone/Fax

Practice location:
  • Phone: 716-438-2500
  • Fax:
Mailing address:
  • Phone: 716-870-2161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number431381-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: