Provider Demographics
NPI:1295038750
Name:FREE, MICHELLE LEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LEE
Last Name:FREE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:LEE
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3176 FREEMAN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MOSINEE
Mailing Address - State:WI
Mailing Address - Zip Code:54455-8984
Mailing Address - Country:US
Mailing Address - Phone:715-693-7423
Mailing Address - Fax:
Practice Address - Street 1:3176 FREEMAN VALLEY RD
Practice Address - Street 2:
Practice Address - City:MOSINEE
Practice Address - State:WI
Practice Address - Zip Code:54455-8984
Practice Address - Country:US
Practice Address - Phone:715-693-7423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI120589163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse