Provider Demographics
NPI:1447798988
Name:DUBBERLY, MICHELLE ANN (APRN, FNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:DUBBERLY
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:ANN
Other - Last Name:DUBBERLY-HOBART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP
Mailing Address - Street 1:4750 WATERS AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6268
Mailing Address - Country:US
Mailing Address - Phone:912-350-5970
Mailing Address - Fax:912-350-5976
Practice Address - Street 1:4750 WATERS AVE STE 302
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6268
Practice Address - Country:US
Practice Address - Phone:912-350-5970
Practice Address - Fax:912-350-5976
Is Sole Proprietor?:No
Enumeration Date:2017-02-04
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN117819363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily