Healthcare Provider Details

I. General information

NPI: 1477835684
Provider Name (Legal Business Name): HEATHER LYNN DUBY N.P.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2011
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15350 N COMMERCE DR STE 202
DEARBORN MI
48120-1234
US

IV. Provider business mailing address

3480 LAWNDALE RD
SAGINAW MI
48603-1622
US

V. Phone/Fax

Practice location:
  • Phone: 616-432-2989
  • Fax:
Mailing address:
  • Phone: 989-284-6724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704244508
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: