Healthcare Provider Details

I. General information

NPI: 1114793957
Provider Name (Legal Business Name): MICHELE FIEGL CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 12/04/2023
Certification Date: 12/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 STATE RD
LANCASTER PA
17601-1812
US

IV. Provider business mailing address

6011 DEVONSHIRE HEIGHTS RD
HARRISBURG PA
17112-3114
US

V. Phone/Fax

Practice location:
  • Phone: 223-287-9000
  • Fax:
Mailing address:
  • Phone: 717-919-2696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberSP028705
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP028705
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: