Provider Demographics
NPI:1093066185
Name:RUMBLE, MICHELLE HAR (RN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:HAR
Last Name:RUMBLE
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 1:2351 EISENHOWER AVENUE
Mailing Address - Street 2:511
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-5359
Mailing Address - Country:US
Mailing Address - Phone:571-970-5634
Mailing Address - Fax:
Practice Address - Street 1:2333 ONTARIO ROAD, NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2627
Practice Address - Country:US
Practice Address - Phone:202-483-8196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1003196163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse