Provider Demographics
NPI:1265403315
Name:HOUGHTON, MICHELLE SUZANNE (RN MSN FNPC)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:SUZANNE
Last Name:HOUGHTON
Suffix:
Gender:F
Credentials:RN MSN FNPC
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Mailing Address - Street 1:3420 22ND PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1314
Mailing Address - Country:US
Mailing Address - Phone:806-725-5844
Mailing Address - Fax:806-723-6532
Practice Address - Street 1:4102 24TH ST
Practice Address - Street 2:SUITE 504
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1806
Practice Address - Country:US
Practice Address - Phone:806-725-6550
Practice Address - Fax:806-723-7493
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2011-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX540577363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143761801Medicaid
NM40258238Medicaid
NM40258238Medicaid
TXP30829Medicare UPIN