MEDICARE: DANIELLE DUQUETTE MD

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
1	207V00000X	Obstetrics & Gynecology Physician	MD00036465	WA
2	207V00000X	Obstetrics & Gynecology Physician	MD2010-0661	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0235120	OTHER	WA	L&I
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679506141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE DUQUETTE MD

Provider Business Mailing Address
First Line	:	1013 CALLE VIANSON
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87507-5013
Country	:	US
Telephone Number	:	505-695-5065
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 BECKNER RD
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87507-3641
Country	:	US
Telephone Number	:	505-772-2000
Fax Number	:	505-772-6297

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	10/03/2024

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Directions to “ DANIELLE DUQUETTE MD” Practice Location

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