Individual
MICHELLE A EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
310 E SAINT JOSEPH ST, GREEN BAY, WI 54301-2242
(920) 433-6073
(920) 431-0333
Mailing address
PO BOX 22040, GREEN BAY, WI 54305-2040
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
100063-875
WI
2084P0800X
Psychiatry Physician
4301508340
MI
2084P0800X
Psychiatry Physician
Primary
81341-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82082
AMERICAN BOARD OF PSYCHIATRY NEUROLOGY
—
Enumeration date
03/09/2018
Last updated
04/12/2023
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