Provider Demographics
NPI:1275500878
Name:SMITH, DEBRA ANN (RNC, MS, WHNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:RNC, MS, WHNP
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Mailing Address - Street 1:49TH MEDICAL GROUP/SGOMW
Mailing Address - Street 2:280 FIRST STREET, BLDG 23
Mailing Address - City:HOLLOMAN AFB
Mailing Address - State:NM
Mailing Address - Zip Code:88330-8273
Mailing Address - Country:US
Mailing Address - Phone:575-572-5874
Mailing Address - Fax:575-572-2259
Practice Address - Street 1:49TH MEDICAL GROUP/SGOMW
Practice Address - Street 2:280 FIRST STREET, BLDG 23
Practice Address - City:HOLLOMAN AFB
Practice Address - State:NM
Practice Address - Zip Code:88330-8273
Practice Address - Country:US
Practice Address - Phone:575-572-5874
Practice Address - Fax:575-572-2259
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2018-04-09
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX702681363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health