Douglas, Michella Glenna

Douglas, Michella Glenna is an individual health care provider with primary practice located at 1400 S Germantown Rd , Germantown TN 38138-2205. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Douglas, Michella Glenna can be contacted via phone (901) 759-3100.

Contact Information

Primary practice address
1400 S Germantown Rd Germantown TN 38138-2205
Phone: (901) 759-3100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 4234 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 4234 Tennessee

Profile Details

NPI number 1053949586
LBN Legal business name Douglas, Michella Glenna
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2020
Last updated May 4th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053949586 NPPES
Mississippi MEDICAID 09376398
Mississippi MEDICAID Q069916

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