Michelle Lea Waldbaum, BSN, RN, CNOR, RNFA

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

95022225 Issued in CA

Practice address

5902 Nugget Cir
Huntington Beach, CA 92647-2131

Phone

(714) 951-1469

NPI assigned

Aug 15, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Surgical Nursing Services Inc.

  • Registered Nurse First Assistant
  • Huntington Beach, CA
  • NPI 1043800691
  NPD Authorized official

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1780138198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5902 NUGGET CIR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926472131",
            "telephone_number": "714-951-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5902 NUGGET CIR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926472131",
            "telephone_number": "714-951-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDBAUM",
        "first_name": "MICHELLE",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "credential": "BSN, RN, CNOR, RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95022225",
            "primary": false
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "CA",
            "license": "95022225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Wagnon, LPCC
• Christy E Wahrer, LISW
• Emile P. Wakim, M.D.
• Paul Emile Wakim, D.O.
• Wal-Mart Stores, Inc.
• Erica Marie Walencewicz, RN
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreen Co

• Registered Nurse First Assistant in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Registered Nurse First Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.