Basic Information
| Provider Information | |||||||||
| NPI: | 1033636188 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEYER | ||||||||
| FirstName: | MICHELLE | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 S RAISINVILLE RD | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481619754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342437340 | ||||||||
| FaxNumber: | 7342435506 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 S RAISINVILLE RD | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481610726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342437340 | ||||||||
| FaxNumber: | 7342435506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 4704293061 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.