| Doctor Name: | MS. DEBRA VIDRINE |
| NPI Number: | 1265506984 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | RN039129 APO4342 |
| Business Practice Address: | 1015 Sanders Pine Prairie, LA - 705763611 |
| Business Phone Number: | 3375992212 |
| Business Fax Number: | 3375460071 |
| Mailing Address: | Po Box 65205, BATON ROUGE |
| State: | LA |
| Postal Code: | 708965205 |
| Phone Number: | 3375460101 |
| Fax Number: | 3375460071 |
| NPI Enumeration Date: | 11/17/2006 |
| NPI Last Update Date: | 10/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN039129 APO4342 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |