Provider Demographics
NPI:1902852759
Name:GARNER, MICHELLE MARIE (CANP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:GARNER
Suffix:
Gender:F
Credentials:CANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 HARCOURT WAY
Mailing Address - Street 2:PO BOX 21
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173
Mailing Address - Country:US
Mailing Address - Phone:765-932-3699
Mailing Address - Fax:
Practice Address - Street 1:911 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CONNERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47331-2051
Practice Address - Country:US
Practice Address - Phone:765-827-1164
Practice Address - Fax:765-827-3876
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001800A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health