MEDICARE: MICHELLE TEAMER

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	376K00000X	Nurse's Aide	400478600405	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3158201	OTHER	OH	OHIO HOME CARE PROGRAM

General Provider Information

NPI Number	:	1285041517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE TEAMER

Provider Business Mailing Address
First Line	:	13722 S PARKWAY DR
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44105-6840
Country	:	US
Telephone Number	:	216-526-7626
Fax Number	:

Provider Business Practice Location Address
First Line	:	13722 S PARKWAY DR
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44105-6840
Country	:	US
Telephone Number	:	216-526-7626
Fax Number	:

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

Provider Enumeration Date	:	07/18/2014
Last Update Date	:	07/18/2014

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Directions to “ MICHELLE TEAMER ” Practice Location

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