Provider Demographics
NPI:1871341040
Name:MCMICHAEL, JOANNE (RN)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:MCMICHAEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-2515
Mailing Address - Country:US
Mailing Address - Phone:609-638-3820
Mailing Address - Fax:
Practice Address - Street 1:2400 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1951
Practice Address - Country:US
Practice Address - Phone:609-587-4778
Practice Address - Fax:609-587-1202
Is Sole Proprietor?:No
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO07575000163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse