Provider Demographics
NPI:1538885975
Name:RICH, MICHELE ANN
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANN
Last Name:RICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 E 32ND ST STE 508
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-2708
Mailing Address - Country:US
Mailing Address - Phone:512-807-3140
Mailing Address - Fax:
Practice Address - Street 1:1015 E 32ND ST STE 508
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2708
Practice Address - Country:US
Practice Address - Phone:512-807-3140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1095953363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care