Provider Demographics
NPI:1578177127
Name:NEMSHAK, MICHELLE (DNP RNC-NIC ACCNS-N)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:NEMSHAK
Suffix:
Gender:F
Credentials:DNP RNC-NIC ACCNS-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4995 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-6108
Mailing Address - Country:US
Mailing Address - Phone:734-649-5047
Mailing Address - Fax:
Practice Address - Street 1:1540 E HOSPITAL DR # 8-356
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-4258
Practice Address - Country:US
Practice Address - Phone:734-232-7896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704173505364SN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SN0000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistNeonatal