Healthcare Provider Details

I. General information

NPI: 1952211666
Provider Name (Legal Business Name): MRS. MICHELLE HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N50W35057 WISCONSIN AVE
OKAUCHEE WI
53069-9763
US

IV. Provider business mailing address

N33W33433 HICKORY LN
NASHOTAH WI
53058-9565
US

V. Phone/Fax

Practice location:
  • Phone: 262-254-9048
  • Fax:
Mailing address:
  • Phone: 262-271-6553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number263139-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: