Doctor Name: | MRS. DEBORAH CHAMPLIN WILSON |
NPI Number: | 1811212830 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 872762 |
Business Practice Address: | 7541 Buccaneer Ave North Bay Village, FL - 331414111 |
Business Phone Number: | 3053325243 |
Business Fax Number: | |
Mailing Address: | 7541 Buccaneer Ave, NORTH BAY VILLAGE |
State: | FL |
Postal Code: | 331414111 |
Phone Number: | 3053325243 |
Fax Number: | |
NPI Enumeration Date: | 04/01/2010 |
NPI Last Update Date: | 04/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 872762 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |