Provider Demographics
NPI:1790055317
Name:BARRON, MICHELE MARGARET (LVN)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:MARGARET
Last Name:BARRON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 E LEMON AVE
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-4117
Mailing Address - Country:US
Mailing Address - Phone:805-801-5380
Mailing Address - Fax:805-740-1982
Practice Address - Street 1:709 E LEMON AVE
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-4117
Practice Address - Country:US
Practice Address - Phone:805-801-5380
Practice Address - Fax:805-740-1982
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN94433164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse