Healthcare Provider Details

I. General information

NPI: 1306786892
Provider Name (Legal Business Name): NATHALIE DUGUAY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16407 SOUTHFIELD RD STE A
ALLEN PARK MI
48101-2571
US

IV. Provider business mailing address

16407 SOUTHFIELD RD STE A
ALLEN PARK MI
48101-2571
US

V. Phone/Fax

Practice location:
  • Phone: 313-271-3000
  • Fax: 313-271-3003
Mailing address:
  • Phone: 313-271-3000
  • Fax: 313-271-3003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4704381286
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number4704381286
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: