Provider Demographics
NPI:1891932703
Name:DIGIOVANNI, MICHELLE A (NP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
Last Name:DIGIOVANNI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6121 N THESTA ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8603
Mailing Address - Country:US
Mailing Address - Phone:559-438-7390
Mailing Address - Fax:559-438-7166
Practice Address - Street 1:880 E TUOLUMNE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-1548
Practice Address - Country:US
Practice Address - Phone:209-669-8300
Practice Address - Fax:559-669-9300
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA432249363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner