Provider Demographics
NPI:1063059772
Name:APPLEGATE, MICAH KATHERINE
Entity type:Individual
Prefix:MRS
First Name:MICAH
Middle Name:KATHERINE
Last Name:APPLEGATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICAH
Other - Middle Name:KATHERINE
Other - Last Name:PRICHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:805 BRADYVILLE PIKE APT 812
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-7812
Mailing Address - Country:US
Mailing Address - Phone:615-489-3880
Mailing Address - Fax:
Practice Address - Street 1:119 W HIGH ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:TN
Practice Address - Zip Code:37190-1226
Practice Address - Country:US
Practice Address - Phone:615-563-5933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPTA0000007324225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant