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Individual

MICHAELA ANN OUTLAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
403 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6034
(423) 431-7111
(423) 431-7092
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 952-2111

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024194962
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
39567
TN

Other

Enumeration date
09/22/2025
Last updated
02/06/2026
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