MEDICARE: MICHELLE LYNN PAGE FNP

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	363LF0000X	Family Nurse Practitioner	2336953	MA
2	363LP2300X	Primary Care Nurse Practitioner	RN566238	CA
3	363LF0000X	Family Nurse Practitioner	CNP171180	ME
4	363LF0000X	Family Nurse Practitioner	AP60911397	WA
5	363LF0000X	Family Nurse Practitioner	NP11518	CA
6	363LF0000X	Family Nurse Practitioner	AP0890	AZ

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
2	D06199741	OTHER	AZ	DRIVERS LIC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992773758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE LYNN PAGE FNP

Provider Business Mailing Address
First Line	:	942 EAST MARICOPA DR
Second Line	:	PO BOX 1504
City	:	SPRINGERVILLE
State	:	AZ
Zip	:	85938-1540
Country	:	US
Telephone Number	:	928-655-4444
Fax Number	:

Provider Business Practice Location Address
First Line	:	4094 4TH AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-2143
Country	:	US
Telephone Number	:	619-515-2545
Fax Number	:

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	09/16/2025

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