Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 566318 | TX |
NPI | 1164485413 |
---|---|
Provider Name | Mrs. Deborah Gray Fletcher |
First Address | Plano, TX 75075-3122 |
Second Address | Richardson, TX 75082-3542 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2006 |
Last Update Date | 08/07/2007 |