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NPI Code Detail

MEDICARE: MISS MICHELLE ELIZABETH BUCHHOLZ RN

MEDICARE: MISS MICHELLE ELIZABETH BUCHHOLZ RN
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 NurseRN645227PA
2363LF0000XFamily Nurse PractitionerSP013706PA

General Provider Information

NPI Number : 1306277132
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MICHELLE ELIZABETH BUCHHOLZ RN
Provider Business Mailing Address
First Line : 260 S BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19102-5021
Country : US
Telephone Number : 215-985-2500
Fax Number :
Provider Business Practice Location Address
First Line : 1900 N 9TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19122-2024
Country : US
Telephone Number : 215-765-6690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2013
Last Update Date : 04/21/2014

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