Provider Demographics
NPI:1033843172
Name:CANFIELD, MICHELE LEE (FNP-BC)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:LEE
Last Name:CANFIELD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5855 BREMO RD STE 207
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1922
Mailing Address - Country:US
Mailing Address - Phone:804-893-8656
Mailing Address - Fax:
Practice Address - Street 1:5855 BREMO RD STE 207
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1922
Practice Address - Country:US
Practice Address - Phone:804-893-8656
Practice Address - Fax:804-287-7018
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024184659363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner