Provider Demographics
NPI:1073809307
Name:CHEN, MICHELE ANN (NP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANN
Last Name:CHEN
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:455 PHILIP BLVD
Mailing Address - Street 2:STE 140
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-8768
Mailing Address - Country:US
Mailing Address - Phone:678-388-1577
Mailing Address - Fax:
Practice Address - Street 1:484 IRVIN CT STE 110
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-5406
Practice Address - Country:US
Practice Address - Phone:770-962-3642
Practice Address - Fax:770-962-3643
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN155861363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health