Provider Demographics
NPI:1336917749
Name:KLUMPENHOWER, MICHELLE A (MED, EDS)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:A
Last Name:KLUMPENHOWER
Suffix:
Gender:F
Credentials:MED, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28993 ELLA DR
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-1135
Mailing Address - Country:US
Mailing Address - Phone:574-514-6982
Mailing Address - Fax:
Practice Address - Street 1:797 CLINIC DR
Practice Address - Street 2:
Practice Address - City:IVYDALE
Practice Address - State:WV
Practice Address - Zip Code:25113-8263
Practice Address - Country:US
Practice Address - Phone:304-286-4200
Practice Address - Fax:304-286-2107
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator