Provider Demographics
NPI:1457319683
Name:YORK, DEBBIE ALICE (FNP-C)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:ALICE
Last Name:YORK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3804 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-2010
Mailing Address - Country:US
Mailing Address - Phone:804-349-6400
Mailing Address - Fax:804-282-5547
Practice Address - Street 1:2008 BREMO RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2443
Practice Address - Country:US
Practice Address - Phone:804-282-5236
Practice Address - Fax:804-282-5547
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017137911163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA096499OtherBC/BS
VA005937N30Medicare ID - Type Unspecified