JACQUELINE LEE MICHUDA APRN-NP NPI 1063239846

NPI Information

  • NPI: 1063239846
  • Provider Name: JACQUELINE LEE MICHUDA, APRN-NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2065 NE TUCSON WAY APT 110
    BEND, OR
    ZIP 97701
  • Phone: (541) 330-3005

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NPI Details

Jacqueline Lee Michuda, APRN-NP is a family nurse practitioner in Bend, OR with 2 years of experience. Jacqueline Lee Michuda, APRN-NP NPI is 1063239846. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2024

The provider's business location address is:

2065 NE TUCSON WAY APT 110
BEND, OR
ZIP 97701-182
Phone: (541) 330-3005
Fax: (541) 383-1883

The NPI 1063239846 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/24/2024 and was last updated on 10/9/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner10033768OREGONNo
2363LF0000XNurse PractitionerFamily10033768OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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