Individual
MICHELLE LEIGH REGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PPCNP-BC
Contact information
Practice address
95 E 120TH ST, GRANT, MI 49327-8623
(231) 834-1350
(231) 834-1355
Mailing address
1615 MICHIGAN AVE, BALDWIN, MI 49304-7984
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704200949
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4749993
—
MI
Enumeration date
07/12/2006
Last updated
08/12/2015
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