Provider Demographics
NPI:1437214921
Name:DUBNICKI, JENNIFER LYNNE-FELDKAMP (NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNNE-FELDKAMP
Last Name:DUBNICKI
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:14650 E OLD US HIGHWAY 12
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1801
Mailing Address - Country:US
Mailing Address - Phone:734-593-5990
Mailing Address - Fax:734-593-5995
Practice Address - Street 1:24 FRANK LLOYD WRIGHT DR
Practice Address - Street 2:LOBBY J2000
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9484
Practice Address - Country:US
Practice Address - Phone:734-747-6766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2016-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704235055363LC1500X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health