Provider Demographics
NPI:1083730576
Name:MICHALOV, ELEANOR MARY (RN)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:MARY
Last Name:MICHALOV
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 PAGE CT
Mailing Address - Street 2:
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-2228
Mailing Address - Country:US
Mailing Address - Phone:410-877-7563
Mailing Address - Fax:
Practice Address - Street 1:119 S HAYS ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3644
Practice Address - Country:US
Practice Address - Phone:410-638-8457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR029756163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health