Provider Demographics
NPI:1134928609
Name:MICHEL, COREY ALAN
Entity type:Individual
Prefix:MR
First Name:COREY
Middle Name:ALAN
Last Name:MICHEL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 NORTHLAND EST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-2776
Mailing Address - Country:US
Mailing Address - Phone:701-320-3640
Mailing Address - Fax:
Practice Address - Street 1:214 NORTHLAND EST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-2776
Practice Address - Country:US
Practice Address - Phone:701-320-3640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant