Provider Demographics
NPI:1114391372
Name:AIAD, MICHELLE ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:AIAD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:347 SMITH AVE N STE 404
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-3354
Mailing Address - Country:US
Mailing Address - Phone:651-220-6624
Mailing Address - Fax:651-220-6064
Practice Address - Street 1:347 SMITH AVE N STE 404
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-3354
Practice Address - Country:US
Practice Address - Phone:651-220-6624
Practice Address - Fax:651-220-6064
Is Sole Proprietor?:No
Enumeration Date:2015-11-25
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN8818363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics