Individual
MS. MICHELLE LEE MOYLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
305 WYE HARBOR DR, QUEENSTOWN, MD 21658-1638
(410) 703-1111
Mailing address
305 WYE HARBOR DR, QUEENSTOWN, MD 21658-1638
(410) 703-1111
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R135096
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
556224401
—
MD
Enumeration date
05/27/2006
Last updated
12/28/2019
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