Provider Demographics
NPI:1114276672
Name:MENKE, DEBRA JAYNE (HEALTH EDUCATOR)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:JAYNE
Last Name:MENKE
Suffix:
Gender:F
Credentials:HEALTH EDUCATOR
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:JAYNE
Other - Last Name:MENKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:1515 EUBANK BLVD SE BLDG 832
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-3453
Mailing Address - Country:US
Mailing Address - Phone:505-844-4237
Mailing Address - Fax:505-845-1046
Practice Address - Street 1:1515 EUBANK BLVD SE BLDG 832
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-3453
Practice Address - Country:US
Practice Address - Phone:505-844-4237
Practice Address - Fax:505-845-1046
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator