# MICHELLE ANDRUS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1114654340
- **Gender:** F
- **Credential:** PMHNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 77648 | ID | — |
| 163WL0100X | Lactation Consultant (Registered Nurse) | L-302839 | ID | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 77648 | ID | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | NUR-APRN-LIC-179716 | MT | — |

## Other

- **Enumeration date:** 08/08/2022
- **Last updated:** 02/27/2025