Provider Demographics
NPI:1467630319
Name:MICHAELS, MARIANNE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MARIANNE
Middle Name:
Last Name:MICHAELS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:MARIANNE
Other - Middle Name:
Other - Last Name:CAUCCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2501 N ORANGE AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4644
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2222 N NEVADA AVE STE 4004
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6832
Practice Address - Country:US
Practice Address - Phone:719-471-7064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-02
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9166128363LA2100X
COC-RXN.0002456-C-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO840789354Medicaid
FL3089819 00Medicaid