Provider Demographics
NPI:1669340956
Name:AUBER, MARY (DNP, FNP, RN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:AUBER
Suffix:
Gender:F
Credentials:DNP, FNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2498 AVALON WOODS DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-7738
Mailing Address - Country:US
Mailing Address - Phone:312-619-6357
Mailing Address - Fax:
Practice Address - Street 1:2498 AVALON WOODS DR
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-7738
Practice Address - Country:US
Practice Address - Phone:312-619-6357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704363617363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily