Provider Demographics
NPI:1013205160
Name:GRABOWSKI, MICHELE D (RN)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:D
Last Name:GRABOWSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6347 BRIDLE TRL
Mailing Address - Street 2:
Mailing Address - City:CADDO MILLS
Mailing Address - State:TX
Mailing Address - Zip Code:75135-6290
Mailing Address - Country:US
Mailing Address - Phone:972-694-2393
Mailing Address - Fax:
Practice Address - Street 1:6347 BRIDLE TRL
Practice Address - Street 2:
Practice Address - City:CADDO MILLS
Practice Address - State:TX
Practice Address - Zip Code:75135-6290
Practice Address - Country:US
Practice Address - Phone:972-694-2393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX795065163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse