Provider Demographics
NPI:1477585727
Name:SNOW, DEBRA ANN (ANP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:SNOW
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:SNOW-FALCONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANP
Mailing Address - Street 1:495 SHADOW MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-5722
Mailing Address - Country:US
Mailing Address - Phone:928-445-7118
Mailing Address - Fax:
Practice Address - Street 1:919 12TH PL
Practice Address - Street 2:SUITE 6
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-1433
Practice Address - Country:US
Practice Address - Phone:928-445-4166
Practice Address - Fax:928-776-9668
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ126332363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health