Provider Demographics
NPI:1629237128
Name:MANSFIELD, MICHELA MARIE (MSN CPNP)
Entity Type:Individual
Prefix:MS
First Name:MICHELA
Middle Name:MARIE
Last Name:MANSFIELD
Suffix:
Gender:F
Credentials:MSN CPNP
Other - Prefix:MS
Other - First Name:MICHELA
Other - Middle Name:MARIE
Other - Last Name:TURPIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34TH ST & CIVIC CENTER BLVD
Mailing Address - Street 2:CHILDRENS HOSPITAL OF PHILADELPHIA ORTHOPAEDICS
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-590-1527
Mailing Address - Fax:215-590-1501
Practice Address - Street 1:3401 CIVIC CENTER BOULEVARD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-1527
Practice Address - Fax:215-590-1501
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00977500363LP0200X
PASP007186363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics