Provider Demographics
NPI:1144233222
Name:PINALES, DEBRA LATTIMER (MS, CRNP)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:LATTIMER
Last Name:PINALES
Suffix:
Gender:F
Credentials:MS, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5007 PATUXENT RIDING LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-3353
Mailing Address - Country:US
Mailing Address - Phone:301-352-5345
Mailing Address - Fax:301-352-5346
Practice Address - Street 1:10 N GREENE ST
Practice Address - Street 2:DIVISION OF CARDIOLOGY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1524
Practice Address - Country:US
Practice Address - Phone:410-605-7000
Practice Address - Fax:410-605-7934
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN57256363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily