Provider Demographics
NPI:1437316288
Name:BARNES, DEBRA (WHCNP/FNP-BC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:WHCNP/FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 W BETHANY HOME RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1997
Mailing Address - Country:US
Mailing Address - Phone:602-841-4860
Mailing Address - Fax:602-841-4861
Practice Address - Street 1:2200 W BETHANY HOME RD
Practice Address - Street 2:SUITE 1
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1997
Practice Address - Country:US
Practice Address - Phone:602-841-4860
Practice Address - Fax:602-841-4861
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4373363LP2300X
AZ070610163W00000X
AZ308363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ449571Medicaid
AZ449571Medicaid