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NPI Code Detail

MEDICARE: MRS. MICHELLE MARIE REYNOLDS RN, BSN, HNB-BC

MEDICARE: MRS. MICHELLE MARIE REYNOLDS RN, BSN, HNB-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
1163W00000XRegistered Nurse4704262407MI

General Provider Information

NPI Number : 1801761283
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE MARIE REYNOLDS RN, BSN, HNB-BC
Provider Business Mailing Address
First Line : 2118 S CAVALIER DR
Second Line :
City : CANTON
State : MI
Zip : 48188-1831
Country : US
Telephone Number : 248-319-6135
Fax Number : 248-567-6858
Provider Business Practice Location Address
First Line : 1961 S TELEGRAPH RD
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48302-0246
Country : US
Telephone Number : 248-319-6135
Fax Number : 248-567-6858
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2025
Last Update Date : 10/07/2025

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