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NPI Code Detail

MEDICARE: MS. MICHELE L KADENKO-MONIRIAN APRN-CNS AGCNS-BC

MEDICARE: MS. MICHELE L KADENKO-MONIRIAN APRN-CNS AGCNS-BC
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
1364SC0200XCritical Care Medicine Clinical Nurse Specialist2811713AIN
2364SG0600XGerontology Clinical Nurse Specialist28117213AIN

General Provider Information

NPI Number : 1467197319
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELE L KADENKO-MONIRIAN APRN-CNS AGCNS-BC
Provider Business Mailing Address
First Line : 14522 WATERBROOK RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46814-9141
Country : US
Telephone Number : 260-312-5083
Fax Number :
Provider Business Practice Location Address
First Line : 2200 RANDALLIA DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4699
Country : US
Telephone Number : 260-312-5083
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2022
Last Update Date : 05/04/2022

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