MEDICARE: MICHELLE L TRAPP CNM, WHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	2075	CA
2	367A00000X	Advanced Practice Midwife	23666	CA
3	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	APRN002620	NV
4	163W00000X	Registered Nurse	765936	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	33-0150193	OTHER	CA	MEDI-CAL

General Provider Information

NPI Number	:	1053637108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE L TRAPP CNM, WHNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:	702-877-5199
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 N NELLIS BLVD STE 6
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-5365
Country	:	US
Telephone Number	:	702-877-5199
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2010
Last Update Date	:	03/05/2024

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