Individual
MICHELLE ANNE VONN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
504 E RIDGEVILLE BLVD, MOUNT AIRY, MD 21771-5942
(301) 703-5452
Mailing address
5707 BEAUTY DR, ELDERSBURG, MD 21784-7072
(443) 417-8472
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103765
NCCPA
—
Enumeration date
06/03/2012
Last updated
08/24/2020
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