Provider Demographics
NPI:1215200563
Name:OFFNER, MICHELLE M (CRNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:OFFNER
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 1:1529 KRIEBEL RD
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-4804
Mailing Address - Country:US
Mailing Address - Phone:267-218-3281
Mailing Address - Fax:
Practice Address - Street 1:11800 WILSHIRE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025
Practice Address - Country:US
Practice Address - Phone:310-231-2124
Practice Address - Fax:310-496-0730
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001882363LA2100X
PASP011885363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care