Provider Demographics
NPI:1487195566
Name:DUBORD, VERNA RENEE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:VERNA
Middle Name:RENEE
Last Name:DUBORD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1886 W AUBURN RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-3865
Mailing Address - Country:US
Mailing Address - Phone:248-290-3111
Mailing Address - Fax:248-290-3100
Practice Address - Street 1:44200 WOODWARD AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5045
Practice Address - Country:US
Practice Address - Phone:248-253-0330
Practice Address - Fax:248-253-1982
Is Sole Proprietor?:No
Enumeration Date:2017-03-09
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704185426163WC0200X, 163WC0400X, 163WD1100X, 163WG0000X, 163WG0600X, 163WH0500X, 163WI0500X, 163WI0600X, 163WN0300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WN0300XNursing Service ProvidersRegistered NurseNephrology