Provider Demographics
NPI:1336577352
Name:BARISHNIKOV, MICHELLE (FNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:BARISHNIKOV
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:SRIJAYANTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 1987
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1987
Mailing Address - Country:US
Mailing Address - Phone:877-685-2164
Mailing Address - Fax:317-705-5060
Practice Address - Street 1:534 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4610
Practice Address - Country:US
Practice Address - Phone:828-213-9090
Practice Address - Fax:828-213-9091
Is Sole Proprietor?:No
Enumeration Date:2013-10-30
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006544363LF0000X
NC234918363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC184TWOtherBCBS NC
NCNCF654BMedicare PIN
NCNCF654AMedicare PIN