Individual
MICHELE DUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
19550 E 39TH ST S STE 220, INDEPENDENCE, MO 64057-2305
(816) 461-6837
Mailing address
19550 E 39TH ST S, INDEPENDENCE, MO 64057-2358
(913) 222-9779
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
14-120092-122
KS
163WG0000X
General Practice Registered Nurse
2007005141
MO
363LG0600X
Gerontology Nurse Practitioner
Primary
2020002094
MO
363LG0600X
Gerontology Nurse Practitioner
53-81698-122
KS
Other
Enumeration date
01/09/2020
Last updated
01/24/2023
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