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NPI Code Detail

MEDICARE: MICHAELA MARIE BARTLOW RN

MEDICARE: MICHAELA MARIE BARTLOW 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 Nurse120625AK

General Provider Information

NPI Number : 1447733084
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAELA MARIE BARTLOW RN
Provider Business Mailing Address
First Line : 1010 ALLISON CIR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99515-3281
Country : US
Telephone Number : 360-931-6027
Fax Number :
Provider Business Practice Location Address
First Line : 670 W FIREWEED LN STE 160
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-2561
Country : US
Telephone Number : 907-770-0862
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2018
Last Update Date : 09/10/2018

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