Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0102203014 | VA |
N | 111NI0900X | Internist | 0102203014 | VA |
Y | 207RP1001X | Pulmonary Disease | 0102203014 | VA |
NPI | 1013234137 |
---|---|
Provider Name | Michelle Renee Alders |
First Address | Mcconnell Afb, KS 67221-3505 |
Second Address | Mcconnell Afb, KS 67221-3505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2010 |
Last Update Date | 09/08/2021 |