Provider Demographics
NPI:1669449732
Name:LEVINE, DEBRA L (NP)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:L
Last Name:LEVINE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:LYNN
Other - Last Name:LEVINE-SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:65 HALF CROWN CIR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-3922
Mailing Address - Country:US
Mailing Address - Phone:508-881-2887
Mailing Address - Fax:
Practice Address - Street 1:67 UNION STREET
Practice Address - Street 2:METROWEST MEDICAL CENTER
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-6776
Practice Address - Country:US
Practice Address - Phone:508-650-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA247231363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA91288OtherFALLON
MANP4787OtherBLUE CROSS SHIELD
MA0700932Medicaid
MA9353597OtherPHCS
Q26802Medicare UPIN
MANP478703Medicare PIN