Provider Demographics
NPI:1548592249
Name:REMLEY, DEBRA SL (ANCC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:SL
Last Name:REMLEY
Suffix:
Gender:F
Credentials:ANCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3947 NELSON DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:MI
Mailing Address - Zip Code:48166-9007
Mailing Address - Country:US
Mailing Address - Phone:734-289-1741
Mailing Address - Fax:248-398-4770
Practice Address - Street 1:3947 NELSON DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:MI
Practice Address - Zip Code:48166-9007
Practice Address - Country:US
Practice Address - Phone:734-289-1741
Practice Address - Fax:248-398-4770
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704106533364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult