Healthcare Provider Details

I. General information

NPI: 1386088706
Provider Name (Legal Business Name): MICHELLE LYNNE PRECOURT DEBBINK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2013
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N 1900 E # 2A200
SALT LAKE CITY UT
84132-5000
US

IV. Provider business mailing address

30 N 1900 E
SALT LAKE CITY UT
84132-0002
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-5501
  • Fax:
Mailing address:
  • Phone: 801-581-5501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number10423941-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301102519
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: