Provider Demographics
NPI:1497850374
Name:NAGURSKI, DEBORAH K (LP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:K
Last Name:NAGURSKI
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 HIGHWAY 13 E
Mailing Address - Street 2:STE. 101
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-6865
Mailing Address - Country:US
Mailing Address - Phone:952-895-9200
Mailing Address - Fax:952-895-1946
Practice Address - Street 1:1601 HIGHWAY 13 E
Practice Address - Street 2:STE. 101
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-6865
Practice Address - Country:US
Practice Address - Phone:952-895-9200
Practice Address - Fax:952-895-1946
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1689103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical