Healthcare Provider Details

I. General information

NPI: 1497007538
Provider Name (Legal Business Name): MICHELLE M BARTLETT RN, MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2012
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 JENKS AVE
PANAMA CITY FL
32405-4310
US

IV. Provider business mailing address

765 ROUTE 10 E STE 203
RANDOLPH NJ
07869-1925
US

V. Phone/Fax

Practice location:
  • Phone: 850-522-1522
  • Fax: 850-522-5925
Mailing address:
  • Phone: 973-659-9991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00404300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11043449
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NO11973500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: