Provider Demographics
NPI:1932155116
Name:STELTZER, MICHELLE MARIE (APNP-AC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:MARIE
Last Name:STELTZER
Suffix:
Gender:F
Credentials:APNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LONGWOOD AVENUE
Mailing Address - Street 2:CHILDREN'S HOSPITAL BOSTON
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-355-8083
Mailing Address - Fax:617-734-1034
Practice Address - Street 1:300 LONGWOOD AVENUE
Practice Address - Street 2:CHILDREN'S HOSPITAL BOSTON
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-355-8083
Practice Address - Fax:617-734-1034
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA279780363LA2100X, 363LP0200X
WI1740363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43949000Medicaid
008006261YOtherHUMANA
MA1932155116Medicaid
MA1932155116OtherTUFTS
MA1932155116Medicaid
008006261YOtherHUMANA
MA1932155116OtherTUFTS
MA1932155116Medicare UPIN
WI43949000Medicaid
MA1932155116Medicare NSC