MEDICARE: MICHELLE RENA MIDDLETON

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	235Z00000X	Speech-Language Pathologist	4457	OK

General Provider Information

NPI Number	:	1639756844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE RENA MIDDLETON

Provider Business Mailing Address
First Line	:	1600 COLORADO AVE
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74003-5313
Country	:	US
Telephone Number	:	620-778-5658
Fax Number	:

Provider Business Practice Location Address
First Line	:	3838 STATE ST STE 200
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-2528
Country	:	US
Telephone Number	:	918-218-7280
Fax Number	:	833-640-8380

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

Provider Enumeration Date	:	03/24/2021
Last Update Date	:	02/22/2026

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Directions to “ MICHELLE RENA MIDDLETON ” Practice Location

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