Provider Demographics
NPI:1134304215
Name:NAUGLE, MICHELE A (CRNP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:A
Last Name:NAUGLE
Suffix:
Gender:F
Credentials:CRNP
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 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2166 S 12TH ST
Practice Address - Street 2:SUITE 402
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-8701
Practice Address - Country:US
Practice Address - Phone:610-969-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP004527A363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care