Provider Demographics
NPI:1548630205
Name:DELEON, MICHELLE BRIGHTON (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:BRIGHTON
Last Name:DELEON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:BRIGHTON
Other - Last Name:BECKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-C
Mailing Address - Street 1:1567 MAIN STREET #100
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610
Mailing Address - Country:US
Mailing Address - Phone:512-351-4405
Mailing Address - Fax:512-295-2068
Practice Address - Street 1:1567 MAIN STREET #100
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610
Practice Address - Country:US
Practice Address - Phone:512-351-4405
Practice Address - Fax:512-295-2068
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129214363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP129214OtherAPRN LICENSE NO.
TX775049OtherRN LICENSE
TX468840YMG2Medicare PIN