Provider Demographics
NPI:1801179056
Name:PASEUR RAY, MICHELLE P (CPM-TN)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:P
Last Name:PASEUR RAY
Suffix:
Gender:F
Credentials:CPM-TN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 CLEO CIR
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-4161
Mailing Address - Country:US
Mailing Address - Phone:423-309-7649
Mailing Address - Fax:
Practice Address - Street 1:212 CLEO CIR
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-4161
Practice Address - Country:US
Practice Address - Phone:423-309-7649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCPM0000000045176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife