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Individual

MRS. MICHELLE BASA LLERENAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Taxonomy

Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
759587
CA
363LN0000X
Neonatal Nurse Practitioner
Primary
95022072
CA
363LN0005X
Critical Care Neonatal Nurse Practitioner
95022072
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
759587
BOARD OF REGISTERED NURSING
CA
Enumeration date
04/15/2020
Last updated
01/03/2023
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