Provider Demographics
NPI:1831573559
Name:VARGO, MICHELE
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:VARGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:CALLOWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4644 MEADOWLARK DR
Mailing Address - Street 2:
Mailing Address - City:MORRISONVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53571
Mailing Address - Country:US
Mailing Address - Phone:608-315-2269
Mailing Address - Fax:
Practice Address - Street 1:4644 MEADOWLARK DR
Practice Address - Street 2:
Practice Address - City:MORRISONVILLE
Practice Address - State:WI
Practice Address - Zip Code:53571
Practice Address - Country:US
Practice Address - Phone:608-315-2269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI141079163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse