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Individual
MICHELLE ANN HEADLEY
Active
Individual
MICHELLE ANN HEADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP 17108
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP 17108
NURSE PRACTITIONER
CA
01
—
RN 684929
REGISTERED NURSE LICENSE
CA
Enumeration date
03/12/2007
Last updated
04/26/2010
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