Provider Demographics
NPI:1366699209
Name:RANKIN, MICHELLE A (AUD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:A
Last Name:RANKIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 COMMERCE PARK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1620
Mailing Address - Country:US
Mailing Address - Phone:734-433-0699
Mailing Address - Fax:734-433-1307
Practice Address - Street 1:1600 COMMERCE PARK DR STE 300
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1620
Practice Address - Country:US
Practice Address - Phone:734-433-0699
Practice Address - Fax:734-433-1307
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000014237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOM29110Medicare PIN