Provider Demographics
NPI:1376819573
Name:ANDERSON, DEBRA S (CPNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:S
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1924 LANDSTOWN CENTRE WAY STE 301
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-1624
Mailing Address - Country:US
Mailing Address - Phone:757-668-7035
Mailing Address - Fax:757-668-7809
Practice Address - Street 1:601 CHILDRENS LN
Practice Address - Street 2:DEPARTMENT OF CARDIOLOGY
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1910
Practice Address - Country:US
Practice Address - Phone:757-668-7213
Practice Address - Fax:757-668-8225
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024115130363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics