Provider Demographics
NPI:1346898228
Name:DUBAY, DEANNA L (DNP PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:L
Last Name:DUBAY
Suffix:
Gender:F
Credentials:DNP PMHNP-BC
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:L
Other - Last Name:MACKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1555 W ERICKSON RD
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:48634-9837
Mailing Address - Country:US
Mailing Address - Phone:906-280-6932
Mailing Address - Fax:
Practice Address - Street 1:946 W MIDLAND RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MI
Practice Address - Zip Code:48611-9400
Practice Address - Country:US
Practice Address - Phone:989-266-3188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704245743363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health