Provider Demographics
NPI:1114196599
Name:LISTER, DEBORAH PATE (RN)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:PATE
Last Name:LISTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:PATE
Other - Last Name:SCHOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7651 CAMERON CT
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-4463
Mailing Address - Country:US
Mailing Address - Phone:251-635-1292
Mailing Address - Fax:
Practice Address - Street 1:7651 CAMERON CT
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-4463
Practice Address - Country:US
Practice Address - Phone:251-635-1292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA666576163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse