Individual
MISS MICHELLE ROQUE DALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3900 AMBASSADOR DR, ANCHORAGE, AK 99508-5922
(907) 729-1680
Mailing address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP127623
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
354050201
—
TX
01
—
AP127623
TX FNP LICENSE
TX
Enumeration date
03/20/2015
Last updated
07/14/2026
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