Healthcare Provider Details

I. General information

NPI: 1770995508
Provider Name (Legal Business Name): MICHELLE MARTINE MEYER PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MICHELLE MARTINE CLARKES NP

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 02/05/2023
Certification Date: 02/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7243 SAWMILL RD STE 105
DUBLIN OH
43016
US

IV. Provider business mailing address

7243 SAWMILL RD STE 105
DUBLIN OH
43016-5005
US

V. Phone/Fax

Practice location:
  • Phone: 614-389-3814
  • Fax: 614-389-3841
Mailing address:
  • Phone: 614-389-3814
  • Fax: 614-389-3841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.15910
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.15910
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: