Individual
MICHELLE F CHEATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
120 EXECUTIVE PARK, ST MATTHEWS, KY 40207-4201
(502) 855-7200
(502) 855-7201
Mailing address
PO BOX 21890, BELFAST, ME 04915-4115
(502) 907-0356
(502) 919-9780
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3516
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7101010100
—
KY
Enumeration date
08/23/2024
Last updated
12/13/2024
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