Provider Demographics
NPI:1437404852
Name:PROOPS, MICHELLE ARCENEAUX (PNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ARCENEAUX
Last Name:PROOPS
Suffix:
Gender:F
Credentials:PNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 QUARRIER ST
Mailing Address - Street 2:APT A
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-3009
Mailing Address - Country:US
Mailing Address - Phone:304-421-1532
Mailing Address - Fax:
Practice Address - Street 1:4407 MACCORKLE AVE SE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-2505
Practice Address - Country:US
Practice Address - Phone:304-925-0392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV74111363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics