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General NPI Number Information
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NPI Number | 1659839355
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Entity Type | Individual
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Provider Name | MICHELLE NMN AUGUSTE APRN
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Gender | Female
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Dates
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Enumeration Date | 03/12/2019
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 279 JACKSON LOOP FL 32724
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City | DELAND
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State | FL
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Zip | 32724-3253
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Country | US
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Telephone | 516-770-5317
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Fax |
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Provider Business Mailing Address
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Address Line | 279 JACKSON LOOP
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City | DELAND
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State | FL
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Zip | 32724-3253
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Country | US
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Telephone | 516-770-5317
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9172208
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95116849
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 12332
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License Number State | VI
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11043756
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 505436
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License Number State | NY
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