Michelle F Dubuisson, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Acoma, NM
NPI 1043723745 · NPPES record last updated Sep 29, 2022
Key facts
- NPI
- 1043723745
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN11003354 (FL)
- Practice address
- 80 B Veterans Blvd
Acoma, NM 87034-8704 - Phone
- (505) 552-5300
- Fax
- (505) 552-5490
- NPI assigned
- Nov 16, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190913001115 | TX | Practitioner - Nurse Practitioner | 6103155304 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11003354 | FL | MD | Family Nurse Practitioner |
| 0000023556 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS IHS Phoenix Area | Current |
Accepting new patients | |
| DHHS IHS Phoenix | Current |
Accepting new patients | |
| Dwic of Tampa Bay, Inc | Past | Accepting new patients |
Interoperability endpoints
- mdubuisson@direct.meditouchehr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0000023556 | TN | |
| Family Nurse Practitioner | 363LF0000X | APRN11003354 | FL | Yes |
Addresses
Primary practice location
80 B Veterans Blvd
Acoma, NM 87034-8704
Mailing address
P.O. Box 130
San Fidel, NM 87049-0130
Phone (505) 552-5300
Other providers in Acoma, NM
- Mallery Chino
- Mindy Chou
- Donita Sue Demontiney
- Dialysis Clinic Inc.
- Michael Diantonio
- Jyoti B Ganji
- Phillip Garcia
- Shalyn Leandra Garcia
- Rodney N Gilliland
- Shawn P Giorgianni
All providers in Acoma, NM · Family Nurse Practitioner in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.