Michelle Dudley, AGPCNP
Nurse Practitioner, Gerontology in Macon, GA. Individual provider (NPI-1).
NPI number1104276708
StatusActive
Last updated in NPPESAug 18, 2020
Details
- NPI
- 1104276708
- Entity type
- Individual (NPI-1)
- Name
- Michelle Dudley
- Credential
- AGPCNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 15, 2016
- Certification date
- Aug 18, 2020
- Last updated
- Aug 18, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LG0600X | Nurse Practitioner, Gerontology | RN147583 | GA | Yes |
Practice location
240 Sheraton Blvd Ste 290Macon, GA 31210-1358
Phone 478-633-8400
Mailing address
240 Sheraton Blvd Ste 290Macon, GA 31210-1358
Phone 478-633-8400
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All 17 Gerontology Nurse Practitioner providers in Macon · All 5,121 providers in Macon
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