Provider Demographics
NPI:1376789511
Name:CARTMELL HERZIG, DEBRA LEA (RN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LEA
Last Name:CARTMELL HERZIG
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 1:3021 RUCKER AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3931
Mailing Address - Country:US
Mailing Address - Phone:425-339-8654
Mailing Address - Fax:425-339-5255
Practice Address - Street 1:3021 RUCKER AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3931
Practice Address - Country:US
Practice Address - Phone:425-339-8654
Practice Address - Fax:425-339-5255
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00057576163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health