Healthcare Provider Details
I. General information
NPI: 1164815940
Provider Name (Legal Business Name): MICHAEL JAMES FURLOW PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/18/2015
Last Update Date: 04/19/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
510 PLAZA DR
FOLSOM CA
95630-4788
US
IV. Provider business mailing address
136 MEADOW OAKS LN
JACKSON MS
39209-2000
US
V. Phone/Fax
- Phone: 916-351-9400
- Fax:
- Phone: 769-798-0275
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 95038780 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 907904 |
| License Number State | MS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: