Provider Demographics
NPI:1215406699
Name:CAMBRIDGE, MICHELE DAWN (NP)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:DAWN
Last Name:CAMBRIDGE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:8051 S EMERSON AVE STE 300
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8630
Practice Address - Country:US
Practice Address - Phone:317-528-8494
Practice Address - Fax:317-528-7118
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2023-01-30
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Provider Licenses
StateLicense IDTaxonomies
IN71008547A363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71008547AOtherINDIANA LICENSE