Provider Demographics
NPI:1912616301
Name:POTE, MICHELLE (LSCW, RN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:POTE
Suffix:
Gender:F
Credentials:LSCW, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 MARIONS WAY
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:DE
Mailing Address - Zip Code:19943-5234
Mailing Address - Country:US
Mailing Address - Phone:267-300-4632
Mailing Address - Fax:
Practice Address - Street 1:217 MARIONS WAY
Practice Address - Street 2:
Practice Address - City:FELTON
Practice Address - State:DE
Practice Address - Zip Code:19943-5234
Practice Address - Country:US
Practice Address - Phone:267-300-4632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD127601041C0700X
PARN693582163WP0809X
PACW0162671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult