Provider Demographics
NPI:1508091885
Name:BARILETTI, DEBRA ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:BARILETTI
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 1:110 SHANE BLDG
Mailing Address - Street 2:BOX 314
Mailing Address - City:ARLINGTON
Mailing Address - State:OR
Mailing Address - Zip Code:97812
Mailing Address - Country:US
Mailing Address - Phone:541-454-2888
Mailing Address - Fax:541-454-2988
Practice Address - Street 1:110 SHANE BLDG.
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:OR
Practice Address - Zip Code:97812
Practice Address - Country:US
Practice Address - Phone:541-454-2888
Practice Address - Fax:541-454-2988
Is Sole Proprietor?:No
Enumeration Date:2009-05-15
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200950037NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily