Individual
MICHELLE FUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
913 S WESTHILL CT, BLOOMINGTON, IN 47403-2119
(812) 336-8121
Mailing address
913 S WESTHILL CT, BLOOMINGTON, IN 47403-2119
(812) 336-8121
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
28169537A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28169537A
INDIANA STATE BOARD OF NURSING LICENSE
IN
Enumeration date
07/09/2013
Last updated
07/09/2013
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