Provider Demographics
NPI:1508003864
Name:LEVAC, MICHELE MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:MARIE
Last Name:LEVAC
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:80 STATE HIGHWAY 310
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617-1436
Mailing Address - Country:US
Mailing Address - Phone:315-386-2325
Mailing Address - Fax:315-386-2781
Practice Address - Street 1:80 STATE HIGHWAY 310
Practice Address - Street 2:SUITE 2
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617-1436
Practice Address - Country:US
Practice Address - Phone:315-386-2325
Practice Address - Fax:315-386-2781
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY525994-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health