Individual
MICHELE MUCHMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
3903 MEDICAL DR STE 300, OGDEN, UT 84403-2317
(801) 387-5600
Mailing address
3903 MEDICAL DR STE 300, OGDEN, UT 84403-2317
(801) 386-5600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
288517-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000055266
MEDICARE PIN
UT
01
—
260022408
RAILROAD MEDICARE
UT
05
—
8760003008007
—
UT
Enumeration date
02/09/2022
Last updated
10/30/2023
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