Provider Demographics
NPI:1053626523
Name:GAGE, DEBRA ANNE (APRN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANNE
Last Name:GAGE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:ANNE
Other - Last Name:MCDERMOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:80 SEYMOUR STRET
Mailing Address - Street 2:HARTFORD HOSPITAL CANCER CENTER
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06102-5037
Mailing Address - Country:US
Mailing Address - Phone:869-674-0088
Mailing Address - Fax:
Practice Address - Street 1:80 FISHER DRIVE
Practice Address - Street 2:HARTFORD HOSPITAL CANCER CENTER
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001
Practice Address - Country:US
Practice Address - Phone:860-674-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004135363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner