Healthcare Provider Details

I. General information

NPI: 1558533810
Provider Name (Legal Business Name): MICHELLE RITCHIE CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 PINNELL ST
RIPLEY WV
25271-9101
US

IV. Provider business mailing address

1370 JOHNSON AVE STE 102
BRIDGEPORT WV
26330-1492
US

V. Phone/Fax

Practice location:
  • Phone: 304-372-2731
  • Fax: 304-372-2749
Mailing address:
  • Phone: 681-342-3463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-42754
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number12754
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: