Provider Demographics
NPI:1568859288
Name:FLINCHUM, MICHELLE SMITH (AGNP-C FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:SMITH
Last Name:FLINCHUM
Suffix:
Gender:F
Credentials:AGNP-C FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 WAY RD
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:27298-9545
Mailing Address - Country:US
Mailing Address - Phone:336-706-1193
Mailing Address - Fax:
Practice Address - Street 1:301 O' KELLY AVENUE
Practice Address - Street 2:
Practice Address - City:ELON
Practice Address - State:NC
Practice Address - Zip Code:27244
Practice Address - Country:US
Practice Address - Phone:336-278-5569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007493363LA2200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health