Basic Information
| Provider Information | |||||||||
| NPI: | 1770685307 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NAVARRO | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | C. - F. N. P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2620 ELM HILL PIKE | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | NEW CASTLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154254211 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2620 ELM HILL PIKE | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372143108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154254211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2006 | ||||||||
| LastUpdateDate: | 05/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 103007 | CO | N | Allopathic & Osteopathic Physicians | Family Medicine | 363L00000X | APN.0003487-NP | CO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | APN.0003487-NP | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 17188041 | 05 | CO | MEDICAID | NAM6601 | 01 | CO | BCBS INDIVIDUAL # | OTHER | NAM6601 | 01 | BCBS INDIVIDUAL | OTHER |