Provider Demographics
NPI:1790578433
Name:FLORA, MICHELLE COLLEEN
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:COLLEEN
Last Name:FLORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 SHAUGHNESSY ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-3259
Mailing Address - Country:US
Mailing Address - Phone:408-338-8803
Mailing Address - Fax:
Practice Address - Street 1:1325 SHAUGHNESSY ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-3259
Practice Address - Country:US
Practice Address - Phone:408-338-8803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program