Provider Demographics
NPI:1568814358
Name:DUBOIS, BERNICE ANNELLE (DNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:BERNICE
Middle Name:ANNELLE
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1058 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:NEW TOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58763-9112
Mailing Address - Country:US
Mailing Address - Phone:701-471-7041
Mailing Address - Fax:
Practice Address - Street 1:1058 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:NEW TOWN
Practice Address - State:ND
Practice Address - Zip Code:58763-9112
Practice Address - Country:US
Practice Address - Phone:701-471-7041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR43132363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily