Provider Demographics
NPI:1558533810
Name:RITCHIE, MICHELLE (CFNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 JOHNSON AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1492
Mailing Address - Country:US
Mailing Address - Phone:681-342-3463
Mailing Address - Fax:
Practice Address - Street 1:122 PINNELL ST
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-9101
Practice Address - Country:US
Practice Address - Phone:304-372-2731
Practice Address - Fax:304-372-2749
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12754163W00000X
WVAPRN-42754363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810008267Medicaid