Church, Michael James

Church, Michael James is an individual health care provider with primary practice located at 6308 8Th Ave , Kenosha WI 53143-5031. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Church, Michael James can be contacted via phone (262) 656-2011.

Contact Information

Primary practice address
6308 8Th Ave Kenosha WI 53143-5031
Phone: (262) 656-2011
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5119-23 Wisconsin
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5119-23 Wisconsin

Profile Details

NPI number 1164056727
LBN Legal business name Church, Michael James
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2020
Last updated Sep 2nd, 2020 - about 6 years ago

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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