Provider Demographics
NPI:1649645417
Name:FRENCH, MICHELLE (RN, IBCLC)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:FRENCH
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:MS
Other - First Name:BRENDA
Other - Middle Name:MICHELLE SUTPHIN
Other - Last Name:FRENCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, IBCLC
Mailing Address - Street 1:9505 MOBILE DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-2753
Mailing Address - Country:US
Mailing Address - Phone:865-200-6309
Mailing Address - Fax:
Practice Address - Street 1:9505 MOBILE DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-2753
Practice Address - Country:US
Practice Address - Phone:865-200-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-05
Last Update Date:2015-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN142322163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant