Beth, Michelle

Beth, Michelle is an individual health care provider with primary practice located at 1218 79Th St , Kenosha WI 53143-6111. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Beth, Michelle can be contacted via phone (262) 658-9500.

Contact Information

Primary practice address
1218 79Th St Kenosha WI 53143-6111
Phone: (262) 658-9500
Fax: (262) 658-9621
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X 2029-026 Wisconsin

Profile Details

NPI number 1093988313
LBN Legal business name Beth, Michelle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 8th, 2008
Last updated Apr 8th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093988313 NPPES
Wisconsin MEDICAID 40727700

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