Doctor Name: | DEBORAH S NALE |
NPI Number: | 1164745998 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 57499 |
Business Practice Address: | 1445 Us Highway 51 Byp E Dyersburg, TN - 380242127 |
Business Phone Number: | 7312861900 |
Business Fax Number: | 7312861939 |
Mailing Address: | 1445 Us Highway 51 Byp E, DYERSBURG |
State: | TN |
Postal Code: | 380242127 |
Phone Number: | 7312861900 |
Fax Number: | 7312861939 |
NPI Enumeration Date: | 03/08/2010 |
NPI Last Update Date: | 10/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 57499 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |