Michele Marie Tellier, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209878 Issued in CA

Practice address

721 River Drive
Suite a
Fort Bragg, CA 95437-5403

Phone

(707) 961-4631

Fax

(707) 964-1192

NPI assigned

Jun 10, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1295961837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 RIVER DRIVE",
            "address_2": "SUITE A",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375403",
            "telephone_number": "707-961-4631",
            "fax_number": "707-964-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 RIVER DRIVE",
            "address_2": "SUITE A",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375403",
            "telephone_number": "707-961-4631",
            "fax_number": "707-964-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLIER",
        "first_name": "MICHELE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-10",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "209878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Suarez Morales
• Kenneth Roger Susman, M.D.
• James William Swallow, MD
• Tapestry Family Services
• Scott Matthew Taubold, PH.D.
• Marleen Laura Tempelaere
• Theophil Jantz, D.O., Inc
• James A Thomas, PA
• Skyler Thomas, LAC
• Shane Eden Thompson

• Family Nurse Practitioner in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.