Provider Demographics
NPI:1265817860
Name:EUL, MICHELLE MARY (NP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARY
Last Name:EUL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:MARY
Other - Last Name:OMDAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2808 COLORADO AVE S
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1827
Mailing Address - Country:US
Mailing Address - Phone:612-599-1128
Mailing Address - Fax:
Practice Address - Street 1:2808 COLORADO AVE S
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1827
Practice Address - Country:US
Practice Address - Phone:612-599-1128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95052267163WN0002X
MN196793-5163W00000X
MNOMD1-04374274363LN0000X
MN5891363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1967935OtherREGISTERED NURSE
CA95003167OtherNURSE PRACTITIONER
104374274OtherNATIONAL CERTIFICATION CORPORATION
MN5891OtherMINNESOTA BOARD OF NURSING