Provider Demographics
NPI:1376585513
Name:KIZER, DEBORAH H (APRN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:H
Last Name:KIZER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 VERNON LN
Mailing Address - Street 2:
Mailing Address - City:ELLOREE
Mailing Address - State:SC
Mailing Address - Zip Code:29047-8637
Mailing Address - Country:US
Mailing Address - Phone:803-826-6006
Mailing Address - Fax:803-874-4693
Practice Address - Street 1:2837 OLD BELLEVILLE RD
Practice Address - Street 2:
Practice Address - City:ST MATTHEWS
Practice Address - State:SC
Practice Address - Zip Code:29135-9010
Practice Address - Country:US
Practice Address - Phone:803-874-2037
Practice Address - Fax:803-874-4693
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC983363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health