Provider Demographics
NPI:1477738730
Name:AUBUCHON, DAWN MARIE (CRNA)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:AUBUCHON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36475 FIVE MILE RD
Mailing Address - Street 2:ANESTHESIA DEPT.
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-1971
Mailing Address - Country:US
Mailing Address - Phone:734-655-1402
Mailing Address - Fax:734-655-1445
Practice Address - Street 1:36475 FIVE MILE RD
Practice Address - Street 2:ANESTHESIA DEPT.
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1971
Practice Address - Country:US
Practice Address - Phone:734-655-1402
Practice Address - Fax:734-655-1445
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704216955367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered