Provider Demographics
NPI:1518946516
Name:NETSCH, DEBRA S (RN NP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:S
Last Name:NETSCH
Suffix:
Gender:F
Credentials:RN NP
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1230 E MAIN ST PO BOX 8674
Mailing Address - Street 2:MANKATO CLINIC LTD
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56002-8674
Mailing Address - Country:US
Mailing Address - Phone:507-625-1811
Mailing Address - Fax:
Practice Address - Street 1:1230 E MAIN ST
Practice Address - Street 2:MANKATO CLINIC AT MAIN STREET
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56002-8674
Practice Address - Country:US
Practice Address - Phone:507-625-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR1284252363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN02Q97NEOtherBCBS
MNHP42077OtherHEALTH PARTNERS
MN124684OtherUCARE
410849339 56001 C112OtherCHAMPUS
MN0120539OtherMEDICA
MN2380346OtherAMERICAS PPO
500009849OtherRR MEDICARE
MNNA2951023876OtherPREFERRED ONE
MN0104221OtherMEDICA
MN459816400Medicaid
IA938357Medicaid
S99545Medicare UPIN
MNHP42077OtherHEALTH PARTNERS