Provider Demographics
NPI:1417020538
Name:MACIONE, MICHELLE STEMPEL (AUD)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:STEMPEL
Last Name:MACIONE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:STEMPEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MCD
Mailing Address - Street 1:6700 WASHINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3405
Mailing Address - Country:US
Mailing Address - Phone:800-328-8602
Mailing Address - Fax:
Practice Address - Street 1:2238 GAUSE BLVD E UNIT A
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-4231
Practice Address - Country:US
Practice Address - Phone:985-649-9131
Practice Address - Fax:985-649-9498
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X, 237700000X
LA5375237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist