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Individual
MICHELLE AUBRIE FENECK
Active
Individual
MICHELLE AUBRIE FENECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
822120
CA
363LF0000X
Family Nurse Practitioner
Primary
26728
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33-0150193
MEDI-CAL
CA
Enumeration date
11/05/2012
Last updated
08/05/2021
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