MICHELLE IRENE KEROUAC RN NPI 1801868500

NPI Information

  • NPI: 1801868500
  • Provider Name: MICHELLE IRENE KEROUAC, RN
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 34800 BOB WILSON DR
    SAN DIEGO, CA
    ZIP 92134
  • Phone: (619) 532-9021

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NPI Details

Michelle Irene Kerouac, RN is a family nurse practitioner in San Diego, CA. Michelle Irene Kerouac, RN NPI is 1801868500. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

34800 BOB WILSON DR
SAN DIEGO, CA
ZIP 92134-098
Phone: (619) 532-9021
Fax: (619) 532-8598

The NPI 1801868500 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/6/2006 and was last updated on 4/21/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered Nurse763720CALIFORNIANo
2363LF0000XNurse PractitionerFamily95001678CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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