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General NPI Number Information
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NPI Number | 1558910984
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Entity Type | Individual
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Provider Name | MICHELLE LEE EISENHAUER APRN
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Gender | Female
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 10 STOCKTON DR
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City | TOMS RIVER
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State | NJ
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Zip | 08755-6433
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Country | US
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Telephone | 732-363-6655
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Fax | 732-363-6656
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Provider Business Mailing Address
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Address Line | PO BOX 142
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City | LANOKA HARBOR
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State | NJ
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Zip | 08734-0142
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Country | US
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Telephone | 732-674-6639
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00956300
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License Number State | NJ
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