Healthcare Provider Details

I. General information

NPI: 1356450522
Provider Name (Legal Business Name): MICHELLE LEE PITCHER APRN, FNP-BC, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 04/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 N 4TH ST
VINCENNES IN
47591-1444
US

IV. Provider business mailing address

207 ROLAND ST
VINCENNES IN
47591-6521
US

V. Phone/Fax

Practice location:
  • Phone: 812-882-7927
  • Fax: 812-886-5307
Mailing address:
  • Phone: 812-881-8981
  • Fax: 812-886-5307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28210304A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number300004288A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71008881A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: