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NPI Code Detail

MEDICARE: MICHELLE HANNAH LM

MEDICARE: MICHELLE HANNAH LM
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
1176B00000XMidwifeMW311FL

General Provider Information

NPI Number : 1528442480
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE HANNAH LM
Provider Business Mailing Address
First Line : 1215 S LIGHTSEY AVE
Second Line :
City : BARTOW
State : FL
Zip : 33830-6536
Country : US
Telephone Number : 863-393-8597
Fax Number :
Provider Business Practice Location Address
First Line : 1525 EDGEWATER BEACH DR
Second Line :
City : LAKELAND
State : FL
Zip : 33805-4737
Country : US
Telephone Number : 863-680-2229
Fax Number : 888-299-6337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2015
Last Update Date : 07/10/2015

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Directions to “ MICHELLE HANNAH LM” Practice Location

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