M'Lissa Ann Duncan, MSMCT, RN, HNB-BC

Primary specialty

Holistic Clinical Nurse SpecialistTaxonomy code 364SH1100X

License

20868H2 Issued in IL

Practice address

804 E Northline Rd
Tuscola, IL 61953-1107

Phone

(217) 974-5735

NPI assigned

Nov 21, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1962227124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 E NORTHLINE RD",
            "city": "TUSCOLA",
            "state": "IL",
            "postal_code": "619531107",
            "telephone_number": "217-974-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 E NORTHLINE RD",
            "city": "TUSCOLA",
            "state": "IL",
            "postal_code": "619531107",
            "telephone_number": "217-974-5735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "M'LISSA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSMCT, RN, HNB-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041397803",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043103777",
            "primary": false
        },
        {
            "code": "364SH1100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Holistic",
            "state": "IL",
            "license": "20868H2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Holistic Clinical Nurse Specialist in Tuscola, IL
• Providers in Tuscola, IL by specialty
• Holistic Clinical Nurse Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.