Michelle Ullrich

Individual provider Active NPI Licensed Practical Nurse · Prattsburgh, NY

NPI 1386285658 · NPPES record last updated Oct 8, 2019

Key facts

NPI
1386285658
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
302921 (NY)
Practice address
30 Porter St
Prattsburgh, NY 14873-9775
Phone
(607) 794-8171
NPI assigned
Oct 8, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
302921NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 302921 NY Yes

Addresses

Primary practice location

30 Porter St
Prattsburgh, NY 14873-9775

Mailing address

30 Porter St
Prattsburgh, NY 14873-9775

Other providers in Prattsburgh, NY

All providers in Prattsburgh, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.