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General NPI Number Information
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NPI Number | 1215200563
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Entity Type | Individual
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Provider Name | MICHELLE M OFFNER CRNP
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Gender | Female
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Dates
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Enumeration Date | 02/17/2012
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Last Update Date | 07/27/2018
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Provider Practice Location Address
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Address Line | 11800 WILSHIRE BLVD STE 300
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City | LOS ANGELES
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State | CA
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Zip | 90025
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Country | US
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Telephone | 310-231-2124
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Fax | 310-496-0730
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Provider Business Mailing Address
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Address Line | 1529 KRIEBEL RD
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City | LANSDALE
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State | PA
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Zip | 19446-4804
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Country | US
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Telephone | 267-218-3281
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 95001882
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP011885
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License Number State | PA
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