Provider Demographics
NPI:1689342529
Name:WOODLIEF, DEBRA L (RN BSN NC-BC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:L
Last Name:WOODLIEF
Suffix:
Gender:F
Credentials:RN BSN NC-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 W WAUCONDA RD
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60051-8064
Mailing Address - Country:US
Mailing Address - Phone:815-790-8809
Mailing Address - Fax:
Practice Address - Street 1:1320 W WAUCONDA RD
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60051-8064
Practice Address - Country:US
Practice Address - Phone:815-790-8809
Practice Address - Fax:815-349-4721
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-04
Last Update Date:2021-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.381867