Provider Demographics
NPI:1861292740
Name:ESPINOSA, MICHELLE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 BIRDSALL AVE
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12542-6103
Mailing Address - Country:US
Mailing Address - Phone:845-514-3555
Mailing Address - Fax:845-514-3555
Practice Address - Street 1:75 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-1816
Practice Address - Country:US
Practice Address - Phone:844-400-1975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY355842363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily