Provider Demographics
NPI:1134821366
Name:PIERRE, MICHELLE M (RN)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:M
Last Name:PIERRE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:M
Other - Last Name:PLAISIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15 STIRLING AVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-5922
Mailing Address - Country:US
Mailing Address - Phone:516-417-7116
Mailing Address - Fax:
Practice Address - Street 1:9508 FLATLANDS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3710
Practice Address - Country:US
Practice Address - Phone:516-417-7116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY550349-01163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY550349-01Medicaid