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NPI Code Detail

MEDICARE: DR. MICHELLE FORTON PMHNP

MEDICARE:  DR. MICHELLE  FORTON  PMHNP
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
1163WP0808XPsychiatric/Mental Health Registered Nurse4704361254MI
2363LP0808XPsychiatric/Mental Health Nurse Practitioner4704361254MI

General Provider Information

NPI Number : 1740053396
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELLE FORTON PMHNP
Provider Business Mailing Address
First Line : 8510 GOODALE AVE
Second Line :
City : UTICA
State : MI
Zip : 48317-5722
Country : US
Telephone Number : 586-646-3682
Fax Number :
Provider Business Practice Location Address
First Line : 1525 UNIVERSITY DR
Second Line :
City : AUBURN HILLS
State : MI
Zip : 48326-2675
Country : US
Telephone Number : 248-373-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2023
Last Update Date : 02/27/2025

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Directions to “ DR. MICHELLE FORTON PMHNP” Practice Location

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