Individual
MICHELLE ANN MISENHEIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
1221 S CREASY LN STE K3, LAFAYETTE, IN 47905-7430
(765) 838-2310
(765) 838-1035
Mailing address
1221 S CREASY LN STE K3, LAFAYETTE, IN 47905-7430
(765) 838-2310
(765) 838-1035
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28096862A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
28096862A
IN
Other
Enumeration date
07/25/2016
Last updated
08/05/2024
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