Provider Demographics
NPI:1043677370
Name:HURLBUT, MICHELE KATHARINE (MS, RN, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:KATHARINE
Last Name:HURLBUT
Suffix:
Gender:
Credentials:MS, RN, FNP-BC
Other - Prefix:MS
Other - First Name:MICHELE
Other - Middle Name:KATHARINE
Other - Last Name:HURLBUT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC FNP-BC
Mailing Address - Street 1:5123 W ST JOE HWY STE 205
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-4028
Mailing Address - Country:US
Mailing Address - Phone:517-492-0611
Mailing Address - Fax:517-492-0699
Practice Address - Street 1:5123 W ST JOE HWY STE 205
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-4028
Practice Address - Country:US
Practice Address - Phone:517-492-0611
Practice Address - Fax:517-492-0699
Is Sole Proprietor?:No
Enumeration Date:2016-01-18
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704302858163W00000X, 363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily