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General NPI Number Information
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NPI Number | 1073809307
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Entity Type | Individual
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Provider Name | MICHELE ANN CHEN NP
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Gender | Female
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Dates
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Enumeration Date | 06/24/2011
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 484 IRVIN CT STE 110
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City | DECATUR
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State | GA
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Zip | 30030-5406
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Country | US
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Telephone | 770-962-3642
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Fax | 770-962-3643
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Provider Business Mailing Address
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Address Line | 455 PHILIP BLVD STE 140
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-8768
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Country | US
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Telephone | 770-962-3642
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Fax | 770-962-3643
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN155861
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN-NP155861
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License Number State | GA
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