Provider Demographics
NPI:1033463492
Name:ARMSTRONG, MICHELE MARIE
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:MARIE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SEDONA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-4775
Mailing Address - Country:US
Mailing Address - Phone:928-542-0202
Mailing Address - Fax:
Practice Address - Street 1:400 SEDONA DR
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-4775
Practice Address - Country:US
Practice Address - Phone:928-542-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant