Provider Demographics
NPI:1457949042
Name:BESAGNO, MICHELA ANNE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:MICHELA
Middle Name:ANNE
Last Name:BESAGNO
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 FELSPAR ST APT 1
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3010
Mailing Address - Country:US
Mailing Address - Phone:925-818-9037
Mailing Address - Fax:
Practice Address - Street 1:1535 FELSPAR ST APT 1
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-3010
Practice Address - Country:US
Practice Address - Phone:925-818-9037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95198717163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse