Provider Demographics
NPI:1003243148
Name:FOX, MICHELLE L (NP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:FOX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:L
Other - Last Name:WESTBOOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:533 CASTLE MANOR CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-3633
Mailing Address - Country:US
Mailing Address - Phone:401-626-6500
Mailing Address - Fax:
Practice Address - Street 1:900 WARREN AVE STE 401
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1430
Practice Address - Country:US
Practice Address - Phone:401-330-2480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN01816363LA2200X, 363LA2200X
IL041.416122163W00000X
RIRN51372163W00000X
IN71005250A363LA2200X, 363LG0600X, 363LP2300X
CT7571363LA2200X
MECNP181062363LA2200X
NH077579-23363LA2200X
IL209.010908363LG0600X
IN71005250B363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIAPRN01816OtherLICENSE
IN264430261Medicare PIN