Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MT199736 | PA |
N | 208600000X | Surgeon | MT199736 | PA |
Y | 2082S0105X | Plastic Hand Surgeon | 52551 | KY |
N | 2086S0105X | Surgery of the Hand | 52551 | KY |
N | 2086S0122X | Plastic and Reconstructive Surgery | 52551 | KY |
NPI | 1215215629 |
---|---|
Provider Name | Debra Anne Bourne |
First Address | Pittsburgh, PA 15213-2500 |
Second Address | Pittsburgh, PA 15213-2500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2011 |
Last Update Date | 05/06/2020 |