Provider Demographics
NPI:1518220342
Name:GONZALES, DEBRA BATTAGLIA (RN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:BATTAGLIA
Last Name:GONZALES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 NICKLAUS ST
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:LA
Mailing Address - Zip Code:70342-2016
Mailing Address - Country:US
Mailing Address - Phone:985-413-0096
Mailing Address - Fax:
Practice Address - Street 1:322 NICKLAUS ST
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:LA
Practice Address - Zip Code:70342-2016
Practice Address - Country:US
Practice Address - Phone:985-413-0096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN074307163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health