Provider Demographics
NPI:1477850311
Name:CAIN, MICHELE RENEE (PHYSICIAN ASSISTANT-)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:RENEE
Last Name:CAIN
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT-
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:RENEE
Other - Last Name:GEHRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 PINE ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-1669
Mailing Address - Country:US
Mailing Address - Phone:605-721-8939
Mailing Address - Fax:605-721-8823
Practice Address - Street 1:350 PINE ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-1669
Practice Address - Country:US
Practice Address - Phone:605-721-8939
Practice Address - Fax:057-218-8236
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2112363A00000X
CO4265363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant