MEDICARE: MICHELLE H BAE CPNP-PC

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	363LP0200X	Pediatric Nurse Practitioner	206995	NC

Other Identifiers

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

General Provider Information

NPI Number	:	1427181502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE H BAE CPNP-PC

Provider Business Mailing Address
First Line	:	236 CANDIA LN
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27519-8810
Country	:	US
Telephone Number	:	919-599-6238
Fax Number	:

Provider Business Practice Location Address
First Line	:	10211 ALM ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27617-8221
Country	:	US
Telephone Number	:	919-385-1160
Fax Number	:	919-385-1186

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	06/26/2023

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