Provider Demographics
NPI:1255831251
Name:DE LA ROSA, DEBRA PAULA LUCILLE (LVN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:PAULA LUCILLE
Last Name:DE LA ROSA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3232 URBICI SOLER DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-2642
Mailing Address - Country:US
Mailing Address - Phone:915-269-0983
Mailing Address - Fax:
Practice Address - Street 1:3232 URBICI SOLER DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-2642
Practice Address - Country:US
Practice Address - Phone:915-269-0983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX330670164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse