Healthcare Provider Details

I. General information

NPI: 1033636188
Provider Name (Legal Business Name): MICHELLE KEHRMEYER N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE NEYER APNP

II. Dates (important events)

Enumeration Date: 08/29/2017
Last Update Date: 12/27/2022
Certification Date: 12/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 E DIVISION ST
FOND DU LAC WI
54935-4560
US

IV. Provider business mailing address

1001 S RAISINVILLE RD
MONROE MI
48161-9754
US

V. Phone/Fax

Practice location:
  • Phone: 209-926-4197
  • Fax: 920-926-4197
Mailing address:
  • Phone: 734-243-7340
  • Fax: 734-243-5506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704293061
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: