Provider Demographics
NPI:1548629686
Name:HAM, MICHELLE (ARNP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:HAM
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:STARCZEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:622 SW 52ND ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-6518
Mailing Address - Country:US
Mailing Address - Phone:239-565-5853
Mailing Address - Fax:
Practice Address - Street 1:885 SE 47TH TER STE C
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-9079
Practice Address - Country:US
Practice Address - Phone:239-471-7688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-17
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9189163363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health