Provider Demographics
NPI:1104186030
Name:VERNA, DEBRA (APN)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:VERNA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 4818
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37831
Mailing Address - Country:US
Mailing Address - Phone:865-712-5478
Mailing Address - Fax:423-562-6106
Practice Address - Street 1:504 S TENNESSEE AVE
Practice Address - Street 2:
Practice Address - City:LA FOLLETTE
Practice Address - State:TN
Practice Address - Zip Code:37766-3649
Practice Address - Country:US
Practice Address - Phone:865-712-5478
Practice Address - Fax:423-562-6106
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN16641363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily