Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 95003196 | CA |
NPI | 1003287608 |
---|---|
Provider Name | Amy Micheli |
First Address | Chico, CA 95926-3310 |
Second Address | Chico, CA 95926-3310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2015 |
Last Update Date | 17/03/2018 |