Provider Demographics
NPI:1588186811
Name:DUBUCHE BERNARD, FRANCETTE (FAMILY NURSE PRACTIT)
Entity Type:Individual
Prefix:
First Name:FRANCETTE
Middle Name:
Last Name:DUBUCHE BERNARD
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 WATERCREST DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-8031
Mailing Address - Country:US
Mailing Address - Phone:678-429-5863
Mailing Address - Fax:
Practice Address - Street 1:398 HIGHWAY 11, SW
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655
Practice Address - Country:US
Practice Address - Phone:888-995-2560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-07
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN205070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily