Basic Information
| Provider Information | |||||||||
| NPI: | 1437404852 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PROOPS | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | ARCENEAUX | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1411 QUARRIER ST | ||||||||
| Address2: | APT A | ||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 253013009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044211532 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4407 MACCORKLE AVE SE | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 253042505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3049250392 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2012 | ||||||||
| LastUpdateDate: | 07/23/2012 | ||||||||
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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 | 363LP0200X | 74111 | WV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.