Provider Demographics
NPI:1114660990
Name:MICHAELS, CHERYL R (RN)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:R
Last Name:MICHAELS
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:PO BOX 81
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53508-0081
Mailing Address - Country:US
Mailing Address - Phone:608-424-3530
Mailing Address - Fax:
Practice Address - Street 1:12 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53508-9105
Practice Address - Country:US
Practice Address - Phone:608-577-0322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI147367-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse