| Doctor Name: | MRS. MICHELLE MCCLUSKEY |
| NPI Number: | 1396756342 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | F.N.P. |
| License Number: | 12179 |
| Business Practice Address: | 204 Shaver Dr Talbott, TN - 378778552 |
| Business Phone Number: | 4235817040 |
| Business Fax Number: | 4235819563 |
| Mailing Address: | Po Box 789, TALBOTT |
| State: | TN |
| Postal Code: | 378770789 |
| Phone Number: | 4235817040 |
| Fax Number: | 4235819563 |
| NPI Enumeration Date: | 08/11/2006 |
| NPI Last Update Date: | 04/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 12179 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |