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NPI Code Detail

MEDICARE: MICHELLE BAINBRIDGE CRNA

MEDICARE: MICHELLE BAINBRIDGE CRNA
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
1367500000XCertified Registered Nurse Anesthetist110438-030WI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1430047952OTHERWIRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073518601
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE BAINBRIDGE CRNA
Provider Business Mailing Address
First Line : 507 S MONROE ST
Second Line :
City : LANCASTER
State : WI
Zip : 53813-2054
Country : US
Telephone Number : 608-723-2143
Fax Number :
Provider Business Practice Location Address
First Line : 507 S MONROE ST
Second Line :
City : LANCASTER
State : WI
Zip : 53813-2054
Country : US
Telephone Number : 608-723-2143
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 01/25/2023

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Directions to “ MICHELLE BAINBRIDGE CRNA” Practice Location

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