Doctor Name: | MRS. DEBRA DEE MUNN |
NPI Number: | 1760842330 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN-BC |
License Number: | 3001904 |
Business Practice Address: | 481 James E. Hannah Drive South Shore, KY - 411759598 |
Business Phone Number: | 6069324334 |
Business Fax Number: | |
Mailing Address: | 297 State Route 3117, SOUTH SHORE |
State: | KY |
Postal Code: | 411759598 |
Phone Number: | 6069238191 |
Fax Number: | |
NPI Enumeration Date: | 02/25/2016 |
NPI Last Update Date: | 02/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 3001904 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |