Provider Demographics
NPI:1407862444
Name:CARR, DEBRA (CNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 COPELAND MILL RD
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8977
Mailing Address - Country:US
Mailing Address - Phone:614-794-0481
Mailing Address - Fax:614-794-3711
Practice Address - Street 1:10330 SAWMILL PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7790
Practice Address - Country:US
Practice Address - Phone:614-794-0481
Practice Address - Fax:614-794-3711
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP 06753363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP62471Medicare UPIN