Provider Demographics
NPI:1386886711
Name:VONGLIS, MICHELE M (RN)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:M
Last Name:VONGLIS
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 1:3170 MAIER LN
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14423-9639
Mailing Address - Country:US
Mailing Address - Phone:585-356-0691
Mailing Address - Fax:
Practice Address - Street 1:3170 MAIER LN
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:NY
Practice Address - Zip Code:14423-9639
Practice Address - Country:US
Practice Address - Phone:585-356-0691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY526401163WH0200X, 163WH1000X, 163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WX0200XNursing Service ProvidersRegistered NurseOncology