Provider Demographics
NPI:1013535491
Name:MCPHERRIN, DEBRA ANN MARTENS (LPN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN MARTENS
Last Name:MCPHERRIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 RIVERSHORES DR
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53090-2531
Mailing Address - Country:US
Mailing Address - Phone:262-424-7209
Mailing Address - Fax:
Practice Address - Street 1:551 RIVERSHORES DR
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53090-2531
Practice Address - Country:US
Practice Address - Phone:262-424-7209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-11
Last Update Date:2020-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI303343164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse