Charles, Michelle Kavcak

Charles, Michelle Kavcak is an sole proprietor health care provider with primary practice located at 4612 N 28Th St , Phoenix AZ 85016-4931. She recently has only one registered license in Nursing Service Providers / School, which is considered as her primary health care specialty. Charles, Michelle Kavcak can be contacted via phone (602) 764-7113.

Contact Information

Primary practice address
4612 N 28Th St Phoenix AZ 85016-4931
Phone: (602) 764-7113
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / School 163WS0200X RN083261 Arizona

Profile Details

NPI number 1376760355
LBN Legal business name Charles, Michelle Kavcak
Credentials RN, MPH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 19th, 2007
Last updated Jul 8th, 2007 - about 17 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 1376760355 NPPES
Arizona MEDICAID 591124

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