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Individual

MICHELLE LYNN SELF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12500 JUDSON RD STE 210, LIVE OAK, TX 78233-4146
(210) 878-0090
Mailing address
12602 TOEPPERWEIN RD STE 208, LIVE OAK, TX 78233-3271

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP145664
TX
363LF0000X
Family Nurse Practitioner
AP145664
TX
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
AP145664
TX

Other

Enumeration date
09/01/2020
Last updated
04/14/2026
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