Provider Demographics
NPI:1982041414
Name:MASSEY, MICHELE (CPM, LM)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 HARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3190
Mailing Address - Country:US
Mailing Address - Phone:817-734-5761
Mailing Address - Fax:817-428-1819
Practice Address - Street 1:1817 HARWOOD CT
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3190
Practice Address - Country:US
Practice Address - Phone:817-734-5761
Practice Address - Fax:817-428-1819
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99176176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife