Provider Demographics
NPI:1194056473
Name:PAGSOLINGAN, MICHELLE ANGELA (CC)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ANGELA
Last Name:PAGSOLINGAN
Suffix:
Gender:F
Credentials:CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 ERSKINE AVE
Mailing Address - Street 2:
Mailing Address - City:KODIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99615-6341
Mailing Address - Country:US
Mailing Address - Phone:907-486-2203
Mailing Address - Fax:907-486-4503
Practice Address - Street 1:303 ERSKINE AVE
Practice Address - Street 2:
Practice Address - City:KODIAK
Practice Address - State:AK
Practice Address - Zip Code:99615-6341
Practice Address - Country:US
Practice Address - Phone:907-486-2203
Practice Address - Fax:907-486-4503
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6639164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse