Provider Demographics
NPI:1659562254
Name:NIEUWKOOP, DEBRA L (APRN, BC; NP-C)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:L
Last Name:NIEUWKOOP
Suffix:
Gender:F
Credentials:APRN, BC; NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3888 HAZELETT DR
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-4032
Mailing Address - Country:US
Mailing Address - Phone:248-682-3426
Mailing Address - Fax:248-682-3426
Practice Address - Street 1:3888 HAZELETT DR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-4032
Practice Address - Country:US
Practice Address - Phone:248-682-3426
Practice Address - Fax:248-682-3426
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704205895163WC2100X, 163WG0000X, 163WG0600X, 163WH0200X, 163WR0400X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WW0000XNursing Service ProvidersRegistered NurseWound Care