Individual
MS. MICHELLE R IACONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-8667
Mailing address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-8667
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AC001468
MD
Other
Enumeration date
11/22/2014
Last updated
05/10/2016
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