Provider Demographics
NPI:1174009591
Name:MAJADIRE, MICHELLE NQOBILE
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:NQOBILE
Last Name:MAJADIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9425 ROLATER RD APT 1438
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-2981
Mailing Address - Country:US
Mailing Address - Phone:214-643-2619
Mailing Address - Fax:
Practice Address - Street 1:9425 ROLATER RD APT 1438
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-2981
Practice Address - Country:US
Practice Address - Phone:214-643-2619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide