Provider Demographics
NPI:1558333708
Name:LADD, DEBRA K (NP)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:K
Last Name:LADD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 160TH ST
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:IA
Mailing Address - Zip Code:50036
Mailing Address - Country:US
Mailing Address - Phone:515-230-3640
Mailing Address - Fax:
Practice Address - Street 1:2419 2ND AVE N.
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501
Practice Address - Country:US
Practice Address - Phone:515-576-2235
Practice Address - Fax:515-576-6863
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1558333708363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care