Provider Demographics
NPI:1679073522
Name:HUML-VANZILE, MICHELLE LEE (RN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEE
Last Name:HUML-VANZILE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LEE
Other - Last Name:HUML
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:134 E MISTLETOE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-3407
Mailing Address - Country:US
Mailing Address - Phone:210-454-1546
Mailing Address - Fax:
Practice Address - Street 1:134 E MISTLETOE AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-3407
Practice Address - Country:US
Practice Address - Phone:210-454-1546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX664278163W00000X
HIRN-86702163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse