Basic Information
Provider Information
NPI: 1033556394
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABRAMS
FirstName: MICHELLE
MiddleName: CAROLINE
NamePrefix: MRS.
NameSuffix:  
Credential: NNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 LOCUST ST
Address2: 5BN
City: PHILADELPHIA
State: PA
PostalCode: 191063914
CountryCode: US
TelephoneNumber: 3363121370
FaxNumber:  
Practice Location
Address1: 3401 CIVIC CENTER BLVD
Address2: CHILDREN'S HOSPITAL OF PHILADELPHIA, N/IICU
City: PHILADELPHIA
State: PA
PostalCode: 191044319
CountryCode: US
TelephoneNumber: 2155903083
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/28/2013
LastUpdateDate: 05/28/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X208709NCN Nursing Service ProvidersRegistered Nurse 
163W00000XRN644376PAN Nursing Service ProvidersRegistered Nurse 
363LN0005XSP012858PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care

No ID Information.


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