Provider Demographics
NPI:1740905934
Name:ARBUCKLE, MICHELLE
Entity type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:
Last Name:ARBUCKLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 KNIGHT LAKE DR APT 272
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-6015
Mailing Address - Country:US
Mailing Address - Phone:405-977-9685
Mailing Address - Fax:
Practice Address - Street 1:7521 KNIGHT LAKE DR APT 272
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-6015
Practice Address - Country:US
Practice Address - Phone:405-977-9685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist