Provider Demographics
NPI:1558600130
Name:KING, DEBRA RUTH (APN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:RUTH
Last Name:KING
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 VONES LN
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-1002
Mailing Address - Country:US
Mailing Address - Phone:908-218-9854
Mailing Address - Fax:
Practice Address - Street 1:1 INDEPENDENCE CT
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-7422
Practice Address - Country:US
Practice Address - Phone:732-739-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-03
Last Update Date:2013-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NNO7005600163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology