Provider Demographics
NPI:1952068595
Name:MURCHISON, MICHELLE (LMBT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MURCHISON
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3077 N MAIN STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-1735
Mailing Address - Country:US
Mailing Address - Phone:916-225-2890
Mailing Address - Fax:
Practice Address - Street 1:3077 N MAIN STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348
Practice Address - Country:US
Practice Address - Phone:916-225-2890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17638225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist