Individual
MRS. MICHELLE KAVCAK CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MPH
Contact information
Practice address
4612 N 28TH ST, PHOENIX, AZ 85016-4931
(602) 764-7113
Mailing address
3912 E WELDON AVE, PHOENIX, AZ 85018-5227
(602) 956-7697
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN083261
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
591124
—
AZ
Enumeration date
04/19/2007
Last updated
07/08/2007
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