Provider Demographics
NPI:1932532231
Name:VENEMAN, MICHELLE LYN (RN, CNP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LYN
Last Name:VENEMAN
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44871-0378
Mailing Address - Country:US
Mailing Address - Phone:419-626-6161
Mailing Address - Fax:419-609-1123
Practice Address - Street 1:5319 HOAG DR STE 210A
Practice Address - Street 2:
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-1494
Practice Address - Country:US
Practice Address - Phone:440-723-5685
Practice Address - Fax:440-723-5686
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-10
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14858-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health