Provider Demographics
NPI:1780768127
Name:MICHAUD, DEBRA LEE (APRN)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:LEE
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:LEE
Other - Last Name:PROULX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26804 RIVER WATCH CT
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-1288
Mailing Address - Country:US
Mailing Address - Phone:352-326-8594
Mailing Address - Fax:
Practice Address - Street 1:2500 CITRUS BLVD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-3063
Practice Address - Country:US
Practice Address - Phone:135-234-7522
Practice Address - Fax:352-347-1073
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY570366-1163W00000X
IL41-352070163W00000X
NV44325163W00000X
CA631932163W00000X
NYF334865-1363L00000X, 363L00000X
FLAPRN2726452363LF0000X, 363LF0000X
FLARNP2726452363LF0000X, 363LF0000X
FL2726452363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner