Provider Demographics
NPI:1073345872
Name:DUNCAN, MAKAYLA ANN (FNP-BC)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:ANN
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MAKAYLA
Other - Middle Name:ANN
Other - Last Name:DATKUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11109 PARKVIEW PLAZA DR # 117
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11109 PARKVIEW PLAZA DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-1701
Practice Address - Country:US
Practice Address - Phone:260-672-6637
Practice Address - Fax:260-458-5355
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71015857A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner