Individual
MICHELLE ELIZABETH CICCONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
734023
NY
163W00000X
Registered Nurse
RN744094
PA
363L00000X
Nurse Practitioner
348238
NY
363L00000X
Nurse Practitioner
Primary
SP024299
PA
Other
Enumeration date
07/01/2021
Last updated
09/03/2021
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