Individual
MR. MICAH WAYNE DUKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN, RN
Contact information
Practice address
1001 TRAVIS RANCH BLVD, STE 2, FORNEY, TX 75126
(469) 910-5902
Mailing address
1102 BAINBRIDGE LN, FORNEY, TX 75126-6466
(940) 206-5207
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
772790
TX
163W00000X
Registered Nurse
958785
TX
163WE0003X
Emergency Registered Nurse
958785
TX
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
1107769
TX
2084P0800X
Psychiatry Physician
1107769
TX
2084P0802X
Addiction Psychiatry Physician
1107769
TX
2084P0804X
Child & Adolescent Psychiatry Physician
1107769
TX
363LA2200X
Adult Health Nurse Practitioner
1107769
TX
363LC1500X
Community Health Nurse Practitioner
1107769
TX
363LF0000X
Family Nurse Practitioner
1107769
TX
363LG0600X
Gerontology Nurse Practitioner
1107769
TX
363LP0200X
Pediatric Nurse Practitioner
1107769
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1107769
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1107769
TX APRN LICENSE
TX
01
—
958785
REGISTERED NURSE LICENSE
TX
Enumeration date
07/05/2021
Last updated
01/04/2024
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