Healthcare Provider Details

I. General information

NPI: 1164219317
Provider Name (Legal Business Name): OLA MICHELLE MICHALEC MBBCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS 601 CHILDREN'S LANE
NORFOLK VA
23507
US

IV. Provider business mailing address

MACON & JOAN VHS AT OLD DOMINION UNIVERSITY-EVMS P.O. BOX 1980, GRADUATE MEDICAL EDUCATION
NORFOLK VA
23501
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-7272
  • Fax:
Mailing address:
  • Phone: 757-668-7272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: