Provider Demographics
NPI:1447239470
Name:DEERWESTER, DEBRA (ARNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:DEERWESTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:MAZZUCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1601 S. MOPAC EPXY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-329-9223
Mailing Address - Fax:
Practice Address - Street 1:1601 S. MOPAC EPXY
Practice Address - Street 2:SUITE 450
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-329-9223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1741172363LF0000X
TX782915363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX314337YUSSOtherMEDICARE PTAN
FLUPINP93552FLMedicare UPIN
TX314337YUSSOtherMEDICARE PTAN