Basic Information
| Provider Information | |||||||||
| NPI: | 1194472415 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRENCH | ||||||||
| FirstName: | MICAH | ||||||||
| MiddleName: | CHARLES | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 486 | ||||||||
| Address2: | |||||||||
| City: | CENTRAL | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 855310486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9289657705 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2016 W 16TH ST | ||||||||
| Address2: | |||||||||
| City: | SAFFORD | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 855464026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9284281500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2022 | ||||||||
| LastUpdateDate: | 03/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 268110 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.