| NPI | 1841402542 |
|---|---|
| Former Name | DEBRA JEAN DIVELBISS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA 057105) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C057105) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2017-02-17 |