Healthcare Provider Details

I. General information

NPI: 1104467786
Provider Name (Legal Business Name): MICHAEL A CELL FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2019
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 HILL ST STE 300
THREE RIVERS MI
49093-2744
US

IV. Provider business mailing address

3245 HEALTH DR STE 100
GRANGER IN
46530-1380
US

V. Phone/Fax

Practice location:
  • Phone: 269-858-3024
  • Fax: 269-273-9040
Mailing address:
  • Phone: 574-647-1088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704235291
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: