Provider Demographics
NPI:1063967263
Name:GOOD, MICHELLE (APRN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:GOOD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 WALL ST
Mailing Address - Street 2:STE 300
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1518
Mailing Address - Country:US
Mailing Address - Phone:603-668-4111
Mailing Address - Fax:603-628-7757
Practice Address - Street 1:1555 ELM ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1203
Practice Address - Country:US
Practice Address - Phone:603-668-4111
Practice Address - Fax:603-628-7757
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH074155-21163WP0808X
NH074155-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health