Provider Demographics
NPI:1558333534
Name:URICK, MICHELE (CRNA)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:URICK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1163 COUNTRY CLUB ROAD
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-1095
Mailing Address - Country:US
Mailing Address - Phone:724-258-1000
Mailing Address - Fax:724-258-1394
Practice Address - Street 1:1163 COUNTRY CLUB ROAD
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-1095
Practice Address - Country:US
Practice Address - Phone:724-258-1000
Practice Address - Fax:724-258-1394
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN185804L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00008519OtherPALMETT GBA
PAUR886772OtherBLUE SHIELD
P00008519OtherPALMETT GBA