Provider Demographics
NPI:1831977172
Name:ORESCANIN, MICHELLE ALIECE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ALIECE
Last Name:ORESCANIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:ALIECE
Other - Last Name:LOEFFLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1300 BIG BEND RD APT 339
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-7762
Mailing Address - Country:US
Mailing Address - Phone:530-205-6829
Mailing Address - Fax:
Practice Address - Street 1:1300 BIG BEND RD APT 339
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63021-7762
Practice Address - Country:US
Practice Address - Phone:530-205-6829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61482827363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty