MEDICARE: MICHELLE RENEE FUHR AGACNP, PMHNP-BC

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
1	363LC0200X	Critical Care Medicine Nurse Practitioner	APRN.CNP.020837	OH
2	363L00000X	Nurse Practitioner	APRN.CNP.020837	OH
3	363LA2200X	Adult Health Nurse Practitioner	APRN.CNP.020837	OH
4	363LG0600X	Gerontology Nurse Practitioner	APRN.CNP.020837	OH
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.020837	OH
6	363LA2100X	Acute Care Nurse Practitioner	APRN.CNP.020837	OH

General Provider Information

NPI Number	:	1114452042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE RENEE FUHR AGACNP, PMHNP-BC

Provider Business Mailing Address
First Line	:	1216 MICHIGAN AVE.
Second Line	:
City	:	WATERVILLE
State	:	OH
Zip	:	43566-8606
Country	:	US
Telephone Number	:	419-740-0738
Fax Number	:	419-273-0586

Provider Business Practice Location Address
First Line	:	1715 INDIAN WOOD CIR STE 200
Second Line	:
City	:	MAUMEE
State	:	OH
Zip	:	43537-4055
Country	:	US
Telephone Number	:	419-740-0738
Fax Number	:	419-273-0568

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2017
Last Update Date	:	03/09/2026

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