Fern, Michelle Marie
Fern, Michelle Marie is an individual health care provider with primary practice located at 80 Minnesota Ave Therapy Connections For Kids, Little Canada MN 55117-1781. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Fern, Michelle Marie can be contacted via phone (651) 206-3697.Contact Information
Primary practice address
80 Minnesota Ave Therapy Connections For Kids
Little Canada MN 55117-1781
Phone: (651) 206-3697
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 5301 | Wisconsin |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 5402 | Minnesota |
Profile Details
| NPI number | 1124129598 |
|---|---|
| LBN Legal business name | Fern, Michelle Marie |
| Credentials | Registered Physical Therapist (RPT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124129598 | NPPES |
| Wisconsin | MEDICAID | 41810700 | |
| Wisconsin | Other | 77G76FE |
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