Provider Demographics
NPI:1326121765
Name:DENIAL, MICHELE
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:DENIAL
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 1:1024 W VIEW PARK DR
Mailing Address - Street 2:
Mailing Address - City:WEST VIEW
Mailing Address - State:PA
Mailing Address - Zip Code:15229-1771
Mailing Address - Country:US
Mailing Address - Phone:412-223-1029
Mailing Address - Fax:441-223-1013
Practice Address - Street 1:1024 W VIEW PARK DR
Practice Address - Street 2:
Practice Address - City:WEST VIEW
Practice Address - State:PA
Practice Address - Zip Code:15229-1771
Practice Address - Country:US
Practice Address - Phone:412-223-1029
Practice Address - Fax:412-223-1013
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2022-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP003769B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41252900Medicaid
WI41252900Medicaid
WI025120270Medicare ID - Type Unspecified