Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | 3041 | AZ |
NPI | 1104872845 |
---|---|
Provider Name | Michele A Ansorge |
First Address | Chesapeake, VA 23321-5537 |
Second Address | Chesapeake, VA 23321-5537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 08/12/2011 |