Individual
MICHELLE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP128991
TX
363LA2100X
Acute Care Nurse Practitioner
AP128991
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
355240801
—
TX
01
—
8212NT
BCBS
TX
Enumeration date
09/17/2015
Last updated
05/21/2019
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