Provider Demographics
NPI:1407323025
Name:DUNCAN, SHIRLEY (FNP)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58383 29 PALMS HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-5891
Mailing Address - Country:US
Mailing Address - Phone:760-365-9305
Mailing Address - Fax:760-365-9309
Practice Address - Street 1:58375 29 PALMS HWY
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-5813
Practice Address - Country:US
Practice Address - Phone:760-365-9305
Practice Address - Fax:760-365-9309
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010030363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health