Provider Demographics
NPI:1669711271
Name:DEMICHELE, JOSEPH (RN)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:DEMICHELE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6411 N ROBERT RD
Mailing Address - Street 2:ROOM 416
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-9146
Mailing Address - Country:US
Mailing Address - Phone:928-853-0155
Mailing Address - Fax:
Practice Address - Street 1:6411 N ROBERT RD
Practice Address - Street 2:ROOM 416
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-9146
Practice Address - Country:US
Practice Address - Phone:928-759-4042
Practice Address - Fax:928-759-4030
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN169380163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool