Provider Demographics
NPI:1699871426
Name:PAQUIN, MICHELLE A (MSN, ARNP, BC, ANP)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:A
Last Name:PAQUIN
Suffix:
Gender:F
Credentials:MSN, ARNP, BC, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:NM
Mailing Address - Zip Code:88044-0424
Mailing Address - Country:US
Mailing Address - Phone:505-233-3068
Mailing Address - Fax:
Practice Address - Street 1:185 DR. MICHAEL JENKINS ROAD
Practice Address - Street 2:CMS MEDICAL UNIT
Practice Address - City:CLAYTON
Practice Address - State:NM
Practice Address - Zip Code:88415
Practice Address - Country:US
Practice Address - Phone:575-374-4005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302142363LA2200X
NMR43548363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health