Provider Demographics
NPI:1386643526
Name:TOGGER, DEBRA ANN (CNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:TOGGER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:TOGGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNP
Mailing Address - Street 1:17770 MACK AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48230-6248
Mailing Address - Country:US
Mailing Address - Phone:313-885-6367
Mailing Address - Fax:313-885-0586
Practice Address - Street 1:17770 MACK AVE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE
Practice Address - State:MI
Practice Address - Zip Code:48230-6248
Practice Address - Country:US
Practice Address - Phone:313-885-6367
Practice Address - Fax:313-885-0586
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704120868363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7981575OtherAETNA
MI7981575OtherAETNA
MIN95130001Medicare ID - Type UnspecifiedPERSONAL ID #
MIP67360Medicare UPIN