Provider Demographics
NPI:1851194971
Name:JEAN-CHARLES, MICHELET
Entity type:Individual
Prefix:
First Name:MICHELET
Middle Name:
Last Name:JEAN-CHARLES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 W COTTAGE GROVE RD
Mailing Address - Street 2:PO BOX 51
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53527-0051
Mailing Address - Country:US
Mailing Address - Phone:608-362-8917
Mailing Address - Fax:
Practice Address - Street 1:451 W COTTAGE GROVE RD
Practice Address - Street 2:PO BOX 51
Practice Address - City:COTTAGE GROVE
Practice Address - State:WI
Practice Address - Zip Code:53527-0051
Practice Address - Country:US
Practice Address - Phone:608-362-8917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care