Provider Demographics
NPI:1245871797
Name:MARCHAND, MICHELLE MARY (PMHNP)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:MARY
Last Name:MARCHAND
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 NEW KARNER RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3854
Mailing Address - Country:US
Mailing Address - Phone:518-456-3614
Mailing Address - Fax:518-456-3689
Practice Address - Street 1:401 NEW KARNER RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3854
Practice Address - Country:US
Practice Address - Phone:518-456-3614
Practice Address - Fax:518-456-3689
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY711346163W00000X
NY1496484363LP0808X
NYF403545-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse