MEDICARE: MS. MICHELLE NICOLE CHAMBERLAIN R.N.

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	163W00000X	Registered Nurse	443694-1	NY

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	:	1710187182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE NICOLE CHAMBERLAIN R.N.

Provider Business Mailing Address
First Line	:	2504 OLINVILLE AVE
Second Line	:	APT # 2B
City	:	BRONX
State	:	NY
Zip	:	10467-7452
Country	:	US
Telephone Number	:	718-547-9743
Fax Number	:

Provider Business Practice Location Address
First Line	:	2504 OLINVILLE AVE
Second Line	:	APT # 2B
City	:	BRONX
State	:	NY
Zip	:	10467-7452
Country	:	US
Telephone Number	:	718-547-9743
Fax Number	:

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

Provider Enumeration Date	:	07/23/2007
Last Update Date	:	07/23/2007

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Directions to “ MS. MICHELLE NICOLE CHAMBERLAIN R.N.” Practice Location

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