Provider Demographics
NPI:1508941733
Name:DEBOVIS, SARA IRIS (NP)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:IRIS
Last Name:DEBOVIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3432
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38502-3432
Mailing Address - Country:US
Mailing Address - Phone:931-528-8593
Mailing Address - Fax:931-528-8214
Practice Address - Street 1:1101 NEAL ST
Practice Address - Street 2:SUITE101
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-0901
Practice Address - Country:US
Practice Address - Phone:931-528-8593
Practice Address - Fax:931-528-8214
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000046089363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily