Pellerin, Michelle R

Pellerin, Michelle R is an individual health care provider with primary practice located at 6801 Phoenix Ave Ste 2 , Fort Smith AR 72903-5299. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, 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. Pellerin, Michelle R can be contacted via phone (479) 384-5378.

Contact Information

Primary practice address
6801 Phoenix Ave Ste 2 Fort Smith AR 72903-5299
Phone: (479) 384-5378
Fax: (479) 385-5379
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA-575 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA-575 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-575 Idaho

Profile Details

NPI number 1780691816
LBN Legal business name Pellerin, Michelle R
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2006
Last updated Jul 12th, 2024 - about last year

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 1780691816 NPPES
Idaho MEDICAID 807321700

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