Provider Demographics
NPI:1447800313
Name:LOCKE, MICHELLE ANN (CNM)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:LOCKE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ANN LOCKE
Other - Last Name:BUFFINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3821 EATON RAPIDS RD
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:MI
Mailing Address - Zip Code:49224-9134
Mailing Address - Country:US
Mailing Address - Phone:505-620-8691
Mailing Address - Fax:
Practice Address - Street 1:3238 CAPITAL AVE SW
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4302
Practice Address - Country:US
Practice Address - Phone:269-979-6432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704187375367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife