Healthcare Provider Details

I. General information

NPI: 1710556063
Provider Name (Legal Business Name): MELISSA DUCHENE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2431 S M 30 STE 116
WEST BRANCH MI
48661-9388
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-2000
US

V. Phone/Fax

Practice location:
  • Phone: 989-343-2487
  • Fax: 989-343-2497
Mailing address:
  • Phone: 844-832-1956
  • Fax: 989-633-5241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704283910
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: