Individual
MICHELLE SIMONE PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-6996
(215) 955-6010
Mailing address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-6996
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN656635
PA
363L00000X
Nurse Practitioner
26NJ01471800
NJ
363LA2100X
Acute Care Nurse Practitioner
Primary
SP026523
PA
Other
Enumeration date
09/26/2022
Last updated
12/02/2023
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