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General NPI Number Information
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NPI Number | 1255118550
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Entity Type | Individual
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Provider Name | MICHELLE JACQUELINE NOXSEL NP
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Gender | Female
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 44B N TU SU LN
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City | BISHOP
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State | CA
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Zip | 93514-8058
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Country | US
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Telephone | 760-873-7611
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Fax | 760-503-4174
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Provider Business Mailing Address
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Address Line | 250 N SEE VEE LN
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City | BISHOP
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State | CA
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Zip | 93514-8130
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Country | US
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Telephone | 760-873-8461
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Fax | 760-503-4174
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 95088369
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95019662
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License Number State | CA
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