Provider Demographics
NPI:1265019277
Name:BABB, MICHELLE DENISE (NP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DENISE
Last Name:BABB
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2320 E MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-1941
Mailing Address - Country:US
Mailing Address - Phone:865-850-4299
Mailing Address - Fax:855-524-4008
Practice Address - Street 1:2320 E MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-1941
Practice Address - Country:US
Practice Address - Phone:865-850-4299
Practice Address - Fax:855-524-4008
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN36354363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN156022071OtherDRIVERS LICENSE