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1184288920
MICHELLE DENISE MCMICKIN
LAGRANGE, GA
NPI
1184288920
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA 197311)
Enumeration Date
2019-04-26
Last Update Date
2019-04-26
Business Address
MICHELLE DENISE MCMICKIN
52 WOODMONT DR
LAGRANGE, GA 30241-7703
Phone number: 229-347-7215
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Mailing Address
MICHELLE DENISE MCMICKIN
52 WOODMONT DR
LAGRANGE, GA 30241-7703
Phone number: 229-347-7215
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