Provider Demographics
NPI:1174990832
Name:BARYCZ, DEBORAH I (RN)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:BARYCZ
Suffix:I
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 1:14003 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-5705
Mailing Address - Country:US
Mailing Address - Phone:586-296-6069
Mailing Address - Fax:
Practice Address - Street 1:2766 W 11 MILE RD
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-3033
Practice Address - Country:US
Practice Address - Phone:248-542-2424
Practice Address - Fax:228-542-5621
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI47041448629163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health