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NPI Code Detail

MEDICARE: MRS. MICHELLE DIANNE DUNCAN FNP

MEDICARE:  MRS. MICHELLE DIANNE DUNCAN  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerF0813185IN
2363L00000XNurse Practitioner71004576AIN

General Provider Information

NPI Number : 1194158691
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE DIANNE DUNCAN FNP
Provider Business Mailing Address
First Line : 2701 E 3RD ST
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47401-5433
Country : US
Telephone Number : 812-332-1419
Fax Number :
Provider Business Practice Location Address
First Line : 2701 E 3RD ST
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47401-5433
Country : US
Telephone Number : 812-332-1419
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2013
Last Update Date : 10/24/2022

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Directions to “ MRS. MICHELLE DIANNE DUNCAN FNP” Practice Location

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