Individual
MICHELLE LOURDES QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
960 JOE FRANK HARRIS PKWY SE, CARTERSVILLE, GA 30120-2129
(470) 490-2142
Mailing address
460 NORTHSIDE CHEROKEE BLVD STE 130, CANTON, GA 30115-8017
(678) 493-2527
(678) 493-5608
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN159750
GA
363L00000X
Nurse Practitioner
Primary
RN159750
GA
363LA2100X
Acute Care Nurse Practitioner
RN159750
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F0508073
AMERICAN ACADEMY OF NURSE PRACTITIONERS CERT PROGRAM
GA
01
—
RN159750
STATE OF GEORGIA BOARD OF NURSING
GA
Enumeration date
07/14/2008
Last updated
09/18/2025
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