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Individual
MICHELLE LEA ANTANOVICH
Active
Individual
MICHELLE LEA ANTANOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP PMHNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP006096B
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP022065
PA
Other
Enumeration date
09/01/2006
Last updated
03/11/2024
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