Provider Demographics
NPI:1417218447
Name:ARMSTRONG, MICHELE D (NP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:D
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:DAWN
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3889
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37602-3889
Mailing Address - Country:US
Mailing Address - Phone:423-794-2457
Mailing Address - Fax:423-283-9480
Practice Address - Street 1:2421 N JOHN B DENNIS HWY
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4773
Practice Address - Country:US
Practice Address - Phone:423-288-3988
Practice Address - Fax:423-288-3273
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171344363L00000X
TNAPN16705363LF0000X
TN16705363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I501877Medicare PIN