Provider Demographics
NPI:1760720213
Name:MICHEL, INDIA S (NP)
Entity Type:Individual
Prefix:MRS
First Name:INDIA
Middle Name:S
Last Name:MICHEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:345 NEPONSET ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-1940
Mailing Address - Country:US
Mailing Address - Phone:508-232-6963
Mailing Address - Fax:
Practice Address - Street 1:345 NEPONSET ST STE 3
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-1988
Practice Address - Country:US
Practice Address - Phone:508-232-6963
Practice Address - Fax:508-297-8258
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP37731363LF0000X
MARN2265845363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily