Healthcare Provider Details

I. General information

NPI: 1629403373
Provider Name (Legal Business Name): MICHELLE LYNN HERMAN MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2013
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3144 CLARKSVILLE ST
PARIS TX
75460-8002
US

IV. Provider business mailing address

3144 CLARKSVILLE ST
PARIS TX
75460-8002
US

V. Phone/Fax

Practice location:
  • Phone: 903-784-8700
  • Fax: 903-784-7502
Mailing address:
  • Phone: 903-784-8700
  • Fax: 903-784-7502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number619079
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: