Provider Demographics
NPI:1598378929
Name:MICHALKE, SHEILA PATRICIA (NP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:PATRICIA
Last Name:MICHALKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60
Mailing Address - Street 2:
Mailing Address - City:MOULTONBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03254-0060
Mailing Address - Country:US
Mailing Address - Phone:609-744-2142
Mailing Address - Fax:
Practice Address - Street 1:8840 CYPRESS WATERS BLVD STE 300
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-4630
Practice Address - Country:US
Practice Address - Phone:609-744-2142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH082324-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty