Individual
MICHELLE R. CASSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
PHS WOUND CLINIC, 5901 HARPER DRIVE NE, ALBUQUERQUE, NM 87109
(505) 823-8870
(505) 823-8875
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
R31349
NM
163WX1500X
Ostomy Care Registered Nurse
R31349
NM
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
R31349
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20372221
—
NM
Enumeration date
10/03/2006
Last updated
12/04/2009
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