Individual provider Active NPI

Michelle Malle Michlin, LPN

  • Licensed Practical Nurse
  • Webster, NY
National Provider Identifier
1710425178
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
186765 Issued in NY
Practice address
1095 Fawnwood Drive
Webster, NY 14580
Phone
(585) 729-3907
NPI assigned
Feb 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 186765 NY Primary

Addresses

Primary practice location

1095 Fawnwood Drive
Webster, NY 14580

Mailing address

1095 Fawn Wood Dr
Webster, NY 14580-9614
Phone (585) 729-3907

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
186765NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1710425178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 FAWN WOOD DR",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145809614",
            "telephone_number": "585-729-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 FAWNWOOD DRIVE",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "14580",
            "telephone_number": "585-729-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHLIN",
        "first_name": "MICHELLE",
        "middle_name": "MALLE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-06",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "186765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; 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.