Provider Demographics
NPI:1518379189
Name:ALI, MICHELE (FNP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 SINTON RD APT 148
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-5291
Mailing Address - Country:US
Mailing Address - Phone:414-788-0008
Mailing Address - Fax:
Practice Address - Street 1:2833 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:ALLOUEZ
Practice Address - State:WI
Practice Address - Zip Code:54301-1635
Practice Address - Country:US
Practice Address - Phone:920-432-4877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995789-NP363LF0000X
AZAP11283363LF0000X
WI8154-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily