Individual provider Active NPI

Michelle Rene Dyer, LPN

  • Licensed Vocational Nurse
  • Lawrenceville, GA
National Provider Identifier
1356167407
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
LPN060140 Issued in GA
Practice address
755 Braves Ave Unit 1447
Lawrenceville, GA 30043-3343
Phone
(678) 557-3887
NPI assigned
Nov 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X LPN060140 GA Primary

Addresses

Primary practice location

755 Braves Ave Unit 1447
Lawrenceville, GA 30043-3343

Mailing address

755 Braves Ave Unit 1447
Lawrenceville, GA 30043-3343
Phone (678) 557-3887

Other names 1

  • Michelle Rene Dobbs Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN060140GAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1356167407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 BRAVES AVE UNIT 1447",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433343",
            "telephone_number": "678-557-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 BRAVES AVE UNIT 1447",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433343",
            "telephone_number": "678-557-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "MICHELLE",
        "middle_name": "RENE",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "GA",
            "license": "LPN060140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "DOBBS",
            "middle_name": "RENE",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.