Provider Demographics
NPI:1689269235
Name:KISS, DEBORAH G
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:G
Last Name:KISS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 OCEAN OAKS LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-3393
Mailing Address - Country:US
Mailing Address - Phone:215-264-4660
Mailing Address - Fax:
Practice Address - Street 1:46 OCEAN OAKS LN
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-3393
Practice Address - Country:US
Practice Address - Phone:215-264-4660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN340514L163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation