Provider Demographics
NPI:1144809542
Name:BETTS, MICHELLE ANN (NP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:BETTS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40412
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-1255
Mailing Address - Country:US
Mailing Address - Phone:248-824-6500
Mailing Address - Fax:
Practice Address - Street 1:500 KIRTS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4135
Practice Address - Country:US
Practice Address - Phone:248-824-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2025-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704234759363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily