Provider Demographics
NPI:1477509941
Name:LE, DEBBIE LE (LPN, PHARMACY TECH)
Entity Type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:LE
Last Name:LE
Suffix:
Gender:F
Credentials:LPN, PHARMACY TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E2373 JULIE LN
Mailing Address - Street 2:
Mailing Address - City:WAUPACA
Mailing Address - State:WI
Mailing Address - Zip Code:54981-9176
Mailing Address - Country:US
Mailing Address - Phone:715-256-4197
Mailing Address - Fax:
Practice Address - Street 1:N2665 COUNTY ROAD QQ
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:WI
Practice Address - Zip Code:54946-0600
Practice Address - Country:US
Practice Address - Phone:715-258-1674
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI30842-031164W00000X
183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered164W00000XNursing Service ProvidersLicensed Practical Nurse
Not Answered183700000XPharmacy Service ProvidersPharmacy Technician