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NPI Code Detail

MEDICARE: MICHELLE SUTTERFIELD

MEDICARE: MICHELLE SUTTERFIELD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34009010AIN

General Provider Information

NPI Number : 1023693983
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE SUTTERFIELD
Provider Business Mailing Address
First Line : 240 N TILLOTSON AVE
Second Line :
City : MUNCIE
State : IN
Zip : 47304-3988
Country : US
Telephone Number : 765-288-1928
Fax Number :
Provider Business Practice Location Address
First Line : 5230 E STOP 11 RD STE 300
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46237-6401
Country : US
Telephone Number : 317-961-5173
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2021
Last Update Date : 05/07/2024

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Directions to “ MICHELLE SUTTERFIELD ” Practice Location

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