Healthcare Provider Details

I. General information

NPI: 1013344928
Provider Name (Legal Business Name): MICHELLE RENEE SCEARSE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2013
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 BALL PARK RD
HARLAN KY
40831-1701
US

IV. Provider business mailing address

37 BALL PARK RD
HARLAN KY
40831-1701
US

V. Phone/Fax

Practice location:
  • Phone: 606-573-4520
  • Fax: 606-573-6392
Mailing address:
  • Phone: 606-573-4520
  • Fax: 606-573-6392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3008314
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3008314
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: