| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MICHELLE RENEE PRATT | 1376968495 | 2022-12-04 |
Michelle Renee Pratt is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1376968495. Registration indicates Michelle Renee Pratt is a provider of access to mental health/behavioral health providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Psych/Mental Health, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Psych/Mental Health, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Ms. Michelle Renee Pratt CRNP |
| Other Provider Name | Michelle Renee Mcclellan |
| Practice Office Address | 708 WILL HALSEY WAY STE C MADISON, AL US |
| Practice Office Telephone | 2563251349 |
| Practice Office Fax | 2563251354 |
| Mailing Address | 1210 GRANDEVIEW BLVD APT 3011 HUNTSVILLE, AL 358242430 US |
| Business Telephone | 2566568263 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1909 Commerce Ave | Cullman, AL 350556151 | 2567344688 / 2567365638 |
| Code | Practice | License No State |
|---|---|---|
| 363LP0808X PRIMARY | Access to Mental Health/Behavioral Health Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Psych/Mental Health All Other Specialties & Provider Types Nurse Practitioner Psych/Mental Health Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 1-053076
AL |
| 330000025 | MEDICAID | AL |