Healthcare Provider Details

I. General information

NPI: 1043677370
Provider Name (Legal Business Name): MICHELE KATHARINE HURLBUT MS, RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELE KATHARINE HURLBUT PMHNP-BC FNP-BC

II. Dates (important events)

Enumeration Date: 01/18/2016
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5123 W ST JOE HWY STE 205
LANSING MI
48917-4028
US

IV. Provider business mailing address

5123 W ST JOE HWY STE 205
LANSING MI
48917-4028
US

V. Phone/Fax

Practice location:
  • Phone: 517-492-0611
  • Fax: 517-492-0699
Mailing address:
  • Phone: 517-492-0611
  • Fax: 517-492-0699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704302858
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704302858
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704302858
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: