Provider Demographics
NPI:1689639452
Name:CLAIR, DEBRA A (PHD CNS)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:A
Last Name:CLAIR
Suffix:
Gender:F
Credentials:PHD CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E STATE ST
Mailing Address - Street 2:WOUND CARE
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4936
Mailing Address - Country:US
Mailing Address - Phone:330-596-7940
Mailing Address - Fax:
Practice Address - Street 1:200 E STATE ST
Practice Address - Street 2:WOUND CARE
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4936
Practice Address - Country:US
Practice Address - Phone:330-596-7940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNS04225364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2459450Medicaid
P24942Medicare UPIN
OH2459450Medicaid