Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | 197 | NV |
Y | 363LN0000X | Nurse Practitioner - Neonatal | APN00197 | NV |
NPI | 1013233287 |
---|---|
Provider Name | Ms. Debra Jean Madison |
First Address | Reno, NV 89533-3147 |
Second Address | Reno, NV 89503-4548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2010 |
Last Update Date | 21/03/2012 |