Michelle Lynn Alten, MSN, CNP
Individual provider Active NPI Family Nurse Practitioner · Sandusky, OH
NPI 1134557291 · NPPES record last updated Oct 2, 2018
Key facts
- NPI
- 1134557291
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- COA 15083-NP (OH)
- Practice address
- 3416 Columbus Ave
Sandusky, OH 44870-5557 - Phone
- (419) 625-2454
- NPI assigned
- Oct 28, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190613002810 | OH | Order and Referring Only - Nurse Practitioner | 2365670445 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA 15083-NP | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fort Ball Emergency Physicians LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | COA 15083-NP | OH | Yes |
Addresses
Primary practice location
3416 Columbus Ave
Sandusky, OH 44870-5557
Mailing address
3416 Columbus Ave
Sandusky, OH 44870-5598
Phone (419) 625-2454
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0094163 | Medicaid | OH | |
| 3025372 | Medicaid | OH |
Other providers in Sandusky, OH
- Timothy V Albrethsen
- Melina Frances Alexander
- Kristin C Allen
- Melissa Allton-Cameron
- Jean Alt
- Amazing Angels LLC
- Amedisys Ohio, L.L.C.
- America'S Best Contacts & Eyeglasses
- American Homepatient, Inc.
- Timothy D Amidon
All providers in Sandusky, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.