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NPI Code Detail

MEDICARE: MICHELLE CUSIMANO

MEDICARE: MICHELLE CUSIMANO
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
1163WM0705XMedical-Surgical Registered Nurse107353CO

General Provider Information

NPI Number : 1366393514
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE CUSIMANO
Provider Business Mailing Address
First Line : 1906 BLAKE AVE
Second Line :
City : GLENWOOD SPRINGS
State : CO
Zip : 81601-4227
Country : US
Telephone Number : 970-399-5412
Fax Number :
Provider Business Practice Location Address
First Line : 1906 BLAKE AVE
Second Line :
City : GLENWOOD SPRINGS
State : CO
Zip : 81601-4227
Country : US
Telephone Number : 970-399-5412
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2026
Last Update Date : 02/04/2026

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Directions to “ MICHELLE CUSIMANO ” Practice Location

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