Michelle Bland
Individual provider Active NPI Registered Nurse · Fruita, CO
NPI 1891196002 · NPPES record last updated Sep 7, 2014
Key facts
- NPI
- 1891196002
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 200156 (CO)
- Practice address
- 1142 Walnut St
Fruita, CO 81521-2099 - Phone
- (970) 773-1827
- NPI assigned
- Sep 7, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200156 | CO | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 200156 | CO | Yes |
Addresses
Primary practice location
1142 Walnut St
Fruita, CO 81521-2099
Mailing address
1142 Walnut St
Fruita, CO 81521-2099
Phone (970) 773-1827
Other names
- Michelle Marie Reardon
Other providers in Fruita, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.