Provider Demographics
NPI:1609201680
Name:DUNCAN, MICHELLE MARIE (NP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10649 BENNETT PKWY
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-7849
Mailing Address - Country:US
Mailing Address - Phone:317-873-6700
Mailing Address - Fax:317-873-8200
Practice Address - Street 1:10649 BENNETT PKWY
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-7849
Practice Address - Country:US
Practice Address - Phone:317-873-6700
Practice Address - Fax:317-873-8200
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004606A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201194460Medicaid
IN201194460Medicaid