Individual
MRS. MICHELLE LEE ROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6840 E BROWN RD, STE 101, MESA, AZ 85207-3759
(480) 285-2150
(480) 285-2151
Mailing address
6840 E BROWN RD, STE 101, MESA, AZ 85207-3759
(480) 285-2150
(480) 285-2151
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
2364
AZ
363AM0700X
Medical Physician Assistant
2364
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1029902
PA CERTIFICATION
AZ
01
—
2364
AZ PHYSICIAN ASST LICENS
AZ
Enumeration date
10/25/2006
Last updated
12/02/2024
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