Doctor Name: | MICHELLE LORRAINE PARDEE |
NPI Number: | 1083708200 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DNP, FNP-BC |
License Number: | 4704169272 |
Business Practice Address: | 19275 Northline Rd Southgate, MI - 481952220 |
Business Phone Number: | 7342872076 |
Business Fax Number: | 7342872731 |
Mailing Address: | 400 N Ingalls St, #3185 ANN ARBOR |
State: | MI |
Postal Code: | 481092003 |
Phone Number: | 7346470132 |
Fax Number: | 7346470351 |
NPI Enumeration Date: | 10/03/2006 |
NPI Last Update Date: | 12/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704169272 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |