Provider Demographics
NPI:1841062460
Name:URQUIZO, MICHELLE DARLENE (FNP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DARLENE
Last Name:URQUIZO
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 1:2333 SAND RD
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:76384-5820
Mailing Address - Country:US
Mailing Address - Phone:940-655-4866
Mailing Address - Fax:
Practice Address - Street 1:4909 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-2547
Practice Address - Country:US
Practice Address - Phone:940-691-0982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1135496363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily