Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | RN183590 | GA |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN183590 | GA |
NPI | 1083056931 |
---|---|
Provider Name | Mrs. Stephanie Ann Debski |
First Address | Gainesville, GA 30503-0658 |
Second Address | Gainesville, GA 30501-3715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2013 |
Last Update Date | 26/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003155687A | (05) | GA |