| Doctor Name: | MRS. DEBRA LYNN MATHIS |
| NPI Number: | 1164649794 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | ARNP 1427202 |
| Business Practice Address: | 1321 Georgia Avenue Baker, FL - 325312605 |
| Business Phone Number: | 8505372700 |
| Business Fax Number: | 8505372702 |
| Mailing Address: | 2804 Remington Green Cir Ste 2, TALLAHASSEE |
| State: | FL |
| Postal Code: | 323081550 |
| Phone Number: | 8503854494 |
| Fax Number: | 8502986054 |
| NPI Enumeration Date: | 04/18/2007 |
| NPI Last Update Date: | 08/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ARNP 1427202 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |