Provider Demographics
NPI:1225660889
Name:BUCCI, DEBORAH JANE (RN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JANE
Last Name:BUCCI
Suffix:
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 1:401 WATTS AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-4354
Mailing Address - Country:US
Mailing Address - Phone:864-630-9130
Mailing Address - Fax:
Practice Address - Street 1:401 WATTS AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-4354
Practice Address - Country:US
Practice Address - Phone:864-630-9130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC48989163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse