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NPI Code Detail

MEDICARE: MICHELLE BAULE

MEDICARE:   MICHELLE  BAULE
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
1163W00000XRegistered Nurse868537NY

General Provider Information

NPI Number : 1073296075
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE BAULE
Provider Business Mailing Address
First Line : 1614 COURT NORTH DR
Second Line :
City : MELVILLE
State : NY
Zip : 11747-8142
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1614 COURT NORTH DR
Second Line :
City : MELVILLE
State : NY
Zip : 11747-8142
Country : US
Telephone Number : 909-253-6792
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2023
Last Update Date : 08/08/2023

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Directions to “ MICHELLE BAULE ” Practice Location

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