Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP10864 | AZ |
N | 363LA2100X | Nurse Practitioner - Acute Care | AP10864 | AZ |
N | 363LA2200X | Nurse Practitioner - Adult Health | AP10864 | AZ |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP10864 | AZ |
NPI | 1104358407 |
---|---|
Provider Name | Dr. Joseph Charles Deboe |
First Address | Tucson, AZ 85712-1041 |
Second Address | Tucson, AZ 85712-1041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2017 |
Last Update Date | 29/01/2018 |