Provider Demographics
NPI:1699368274
Name:MCNAIR, MICHELLE GREEN
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:GREEN
Last Name:MCNAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 HICKORY BRANCHES CLOSE
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-9210
Mailing Address - Country:US
Mailing Address - Phone:252-258-8245
Mailing Address - Fax:
Practice Address - Street 1:202 HICKORY BRANCHES CLOSE
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-9210
Practice Address - Country:US
Practice Address - Phone:252-258-8245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program