Provider Demographics
NPI:1841339777
Name:MICHIE HEALTHCARE ASSOCIATES, LLC
Entity type:Organization
Organization Name:MICHIE HEALTHCARE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKNEY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:731-239-9470
Mailing Address - Street 1:5823 HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:MICHIE
Mailing Address - State:TN
Mailing Address - Zip Code:38357-5175
Mailing Address - Country:US
Mailing Address - Phone:731-239-9470
Mailing Address - Fax:901-239-9472
Practice Address - Street 1:5823 HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:MICHIE
Practice Address - State:TN
Practice Address - Zip Code:38357-5175
Practice Address - Country:US
Practice Address - Phone:731-239-9470
Practice Address - Fax:901-239-9472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006154363LF0000X
TNAPN0000005664363LF0000X
TNAPN0000006345363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3731594Medicare ID - Type Unspecified
TNP06012Medicare UPIN
TNP16098Medicare UPIN
TNS77386Medicare UPIN