Provider Demographics
NPI:1194472415
Name:FRENCH, MICAH CHARLES (FNP-C)
Entity Type:Individual
Prefix:
First Name:MICAH
Middle Name:CHARLES
Last Name:FRENCH
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 486
Mailing Address - Street 2:
Mailing Address - City:CENTRAL
Mailing Address - State:AZ
Mailing Address - Zip Code:85531-0486
Mailing Address - Country:US
Mailing Address - Phone:928-965-7705
Mailing Address - Fax:
Practice Address - Street 1:2016 W 16TH ST
Practice Address - Street 2:
Practice Address - City:SAFFORD
Practice Address - State:AZ
Practice Address - Zip Code:85546-4026
Practice Address - Country:US
Practice Address - Phone:928-428-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ268110363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily