MICHELLE LOURDES QUEEN FNP-C NPI 1861656365

NPI Information

NPI: 1861656365
Provider Name: MICHELLE LOURDES QUEEN, FNP-C
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
460 NORTHSIDE CHEROKEE BLVD STE 130
CANTON, GA
ZIP 30115
Phone: (678) 493-2527
Get Directions

Michelle Lourdes Queen, FNP-C is an acute care nurse practitioner in Canton, GA with 16 years of experience. Michelle Lourdes Queen, FNP-C NPI is 1861656365. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

460 NORTHSIDE CHEROKEE BLVD STE 130
CANTON, GA
ZIP 30115-017
Phone: (678) 493-2527
Fax: (678) 493-5608

The NPI 1861656365 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/14/2008 and was last updated on 4/19/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		RN159750	GEORGIA	No
2	363LA2100X	Nurse Practitioner	Acute Care	RN159750	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	RN159750	OTHER	GEORGIA	STATE OF GEORGIA BOARD OF NURSING
2	F0508073	OTHER	GEORGIA	AMERICAN ACADEMY OF NURSE PRACTITIONERS CERT PROGRAM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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