Provider Demographics
NPI:1407186638
Name:MARTIN, DEBRA KAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:KAY
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10181 E CORTE MADERA FINA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-5066
Mailing Address - Country:US
Mailing Address - Phone:520-240-3861
Mailing Address - Fax:
Practice Address - Street 1:9184 E VALENCIA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-4902
Practice Address - Country:US
Practice Address - Phone:520-574-8328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-11
Last Update Date:2022-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS014259183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist