Provider Demographics
NPI:1033689591
Name:MAUCH, MICHELLE LYNN (APRN-CNP)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LYNN
Last Name:MAUCH
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Gender:F
Credentials:APRN-CNP
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Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:MLC 6015
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-0800
Mailing Address - Fax:513-636-0823
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:MLC 6015
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-0800
Practice Address - Fax:513-636-0823
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2019-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023911363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health