Provider Demographics
NPI:1790354793
Name:ENRIQUES, MICHELLE ANTOINETTE (BSN, RN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANTOINETTE
Last Name:ENRIQUES
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1676 GRAVIER ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2106
Mailing Address - Country:US
Mailing Address - Phone:504-568-8733
Mailing Address - Fax:504-568-5979
Practice Address - Street 1:1676 GRAVIER ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2106
Practice Address - Country:US
Practice Address - Phone:504-568-8733
Practice Address - Fax:504-568-5979
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN084557163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health