Provider Demographics
NPI:1366265316
Name:CORTEZ, MICHELLE MARIE (CHW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:MARIE
Other - Last Name:ESTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1108 TROTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3711
Mailing Address - Country:US
Mailing Address - Phone:810-931-5536
Mailing Address - Fax:
Practice Address - Street 1:2480 S CENTER RD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48519-1152
Practice Address - Country:US
Practice Address - Phone:810-444-0967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker