Provider Demographics
NPI:1568412781
Name:KRUPNICK, DEBRA ANN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:KRUPNICK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3181 CLEARWATER DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7101
Mailing Address - Country:US
Mailing Address - Phone:928-515-1755
Mailing Address - Fax:928-515-2455
Practice Address - Street 1:3181 CLEARWATER DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7101
Practice Address - Country:US
Practice Address - Phone:928-515-1755
Practice Address - Fax:928-515-2455
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAPO522363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTKRUP05338662OtherBC BS OF VERMONT
VT043346203 0078OtherCIGNA
VT854125OtherMVP
VT043346203012OtherTRICARE
VT0NP1198Medicaid
VTMB0243991OtherDEA
VTS62710Medicare UPIN
AZS62710Medicare UPIN
VTNP1198Medicare ID - Type Unspecified