Provider Demographics
NPI:1861681843
Name:RABIDEAU, MICHELLE MARGARET (LPN)
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:MARGARET
Last Name:RABIDEAU
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 IRISH SETTLEMENT RD
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-7612
Mailing Address - Country:US
Mailing Address - Phone:518-566-8259
Mailing Address - Fax:
Practice Address - Street 1:721 IRISH SETTLEMENT RD
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-7612
Practice Address - Country:US
Practice Address - Phone:518-566-8259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248879-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse