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General NPI Number Information
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NPI Number | 1427181502
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Entity Type | Individual
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Provider Name | MICHELLE H BAE CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 10211 ALM ST
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City | RALEIGH
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State | NC
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Zip | 27617-8221
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Country | US
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Telephone | 919-385-1160
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Fax | 919-385-1186
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Provider Business Mailing Address
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Address Line | 236 CANDIA LN
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City | CARY
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State | NC
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Zip | 27519-8810
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Country | US
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Telephone | 919-599-6238
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 206995
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License Number State | NC
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