Individual
MICHELLE LYNN ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-8355
(270) 798-8400
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-8355
(270) 798-8400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1584
TN
363AM0700X
Medical Physician Assistant
PA2332
KY
363AM0700X
Medical Physician Assistant
TC683
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100523490
—
KY
Enumeration date
03/21/2008
Last updated
07/01/2026
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