Provider Demographics
NPI:1639394794
Name:ABBET, DEBBIE LYNN
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:LYNN
Last Name:ABBET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:LYNN
Other - Last Name:HADDOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7204 E 47TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-5903
Mailing Address - Country:US
Mailing Address - Phone:918-384-0459
Mailing Address - Fax:
Practice Address - Street 1:7204 E 47TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-5903
Practice Address - Country:US
Practice Address - Phone:918-384-0459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKPB00389957 A0130OtherPA# NON-EMERGENCY T