Provider Demographics
NPI:1336649482
Name:MCARTHUR, MICHELLE CAMILLE (BSN, RN, CDE)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CAMILLE
Last Name:MCARTHUR
Suffix:
Gender:F
Credentials:BSN, RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6134 145TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-8974
Mailing Address - Country:US
Mailing Address - Phone:616-994-3229
Mailing Address - Fax:
Practice Address - Street 1:175 S WAVERLY RD STE A
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-7906
Practice Address - Country:US
Practice Address - Phone:616-394-3410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704250528163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator