Healthcare Provider Details

I. General information

NPI: 1790606432
Provider Name (Legal Business Name): MICHIE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5823 HIGHWAY 22
MICHIE TN
38357-5175
US

IV. Provider business mailing address

5823 HIGHWAY 22
MICHIE TN
38357-5175
US

V. Phone/Fax

Practice location:
  • Phone: 731-239-9470
  • Fax: 731-239-9472
Mailing address:
  • Phone: 731-239-9470
  • Fax: 731-239-9472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRI FREEMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 731-315-8703