| Doctor Name: | MICHELLE WATHIER |
| NPI Number: | 1124436217 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 28167408A |
| Business Practice Address: | 2272 North Main Street Minute Clinic Crown Point, IN - 46307 |
| Business Phone Number: | 7089035876 |
| Business Fax Number: | |
| Mailing Address: | 5004 W 121st Ave, CROWN POINT |
| State: | IN |
| Postal Code: | 463078743 |
| Phone Number: | 7089035876 |
| Fax Number: | |
| NPI Enumeration Date: | 08/01/2014 |
| NPI Last Update Date: | 08/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 28167408A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |