Gonzales, Debra

Gonzales, Debra is an individual health care provider with primary practice located at 1025 N Country Club Dr , Mesa AZ 85201-3307. She recently has only one registered license in Nursing Service Providers / School, which is considered as her primary health care specialty. Gonzales, Debra can be contacted via phone (480) 472-7876.

Contact Information

Primary practice address
1025 N Country Club Dr Mesa AZ 85201-3307
Phone: (480) 472-7876
Fax: (480) 472-7878
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / School 163WS0200X RN060517 Arizona

Profile Details

NPI number 1144200288
LBN Legal business name Gonzales, Debra
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2006
Last updated Nov 17th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144200288 NPPES
Arizona MEDICAID 524274

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