Doctor Name: | MICHELE EXWORTHY |
NPI Number: | 1659763647 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | 0119014-30 |
Business Practice Address: | 237 Gale St Apt 11 Oconto, WI - 541531094 |
Business Phone Number: | 9206729001 |
Business Fax Number: | |
Mailing Address: | 237 Gale St Apt 11, OCONTO |
State: | WI |
Postal Code: | 541531094 |
Phone Number: | 9206729001 |
Fax Number: | |
NPI Enumeration Date: | 02/27/2015 |
NPI Last Update Date: | 02/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WG0000X |
License Number: | 0119014-30 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | General Practice |
Taxonomy Definition: |