Provider Demographics
NPI:1184196669
Name:FICKLING, DEBRA ANN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:FICKLING
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:FICKLING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN FNP-C
Mailing Address - Street 1:6470 TIPPIN AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8143
Mailing Address - Country:US
Mailing Address - Phone:850-741-2878
Mailing Address - Fax:
Practice Address - Street 1:6470 TIPPIN AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8143
Practice Address - Country:US
Practice Address - Phone:850-741-2878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000399363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily