Provider Demographics
NPI:1518414671
Name:DUBRAY, JUANITA KAY (RN)
Entity Type:Individual
Prefix:
First Name:JUANITA
Middle Name:KAY
Last Name:DUBRAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JUANITA
Other - Middle Name:KAY
Other - Last Name:GUARDIPEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3011
Mailing Address - Street 2:
Mailing Address - City:BROWNING
Mailing Address - State:MT
Mailing Address - Zip Code:59417-3011
Mailing Address - Country:US
Mailing Address - Phone:406-338-4415
Mailing Address - Fax:
Practice Address - Street 1:760 HOSPITAL CIRCLE
Practice Address - Street 2:
Practice Address - City:BROWNING
Practice Address - State:MT
Practice Address - Zip Code:59417-3011
Practice Address - Country:US
Practice Address - Phone:406-338-6377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-30114163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse