Provider Demographics
NPI:1992347298
Name:HASTINGS, MICHELLE LEE (FNP - C)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEE
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:FNP - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14042 CRONESE RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-5611
Mailing Address - Country:US
Mailing Address - Phone:760-559-3925
Mailing Address - Fax:
Practice Address - Street 1:13024 HESPERIA RD STE 103
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-8303
Practice Address - Country:US
Practice Address - Phone:750-241-3547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1029864363LF0000X
CANP95012777363LF0000X, 207RC0001X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology