Provider Demographics
NPI:1700147253
Name:MICHEL, FABIENNE (RNP)
Entity Type:Individual
Prefix:MISS
First Name:FABIENNE
Middle Name:
Last Name:MICHEL
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 LINDEN BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4025
Mailing Address - Country:US
Mailing Address - Phone:516-285-2850
Mailing Address - Fax:
Practice Address - Street 1:1975 LINDEN BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4025
Practice Address - Country:US
Practice Address - Phone:516-285-2850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305659363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner