Provider Demographics
NPI:1083986731
Name:HOLBROOK, DEBRA E (RN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:E
Last Name:HOLBROOK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3992 STATE HIGHWAY 2
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-9022
Mailing Address - Country:US
Mailing Address - Phone:518-279-4600
Mailing Address - Fax:518-279-1918
Practice Address - Street 1:3992 STATE HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-9022
Practice Address - Country:US
Practice Address - Phone:518-279-4600
Practice Address - Fax:518-279-1918
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259895-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool