Provider Demographics
NPI:1700862265
Name:CARR, DEBRA MORGAN (ARNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:MORGAN
Last Name:CARR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:LYNN
Other - Last Name:CARR MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1190 E NINE MILE RD
Mailing Address - Street 2:SENIOR HEALTH SERVICES
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-1651
Mailing Address - Country:US
Mailing Address - Phone:850-477-0401
Mailing Address - Fax:850-477-2183
Practice Address - Street 1:1190 E NINE MILE RD
Practice Address - Street 2:SENIOR HEALTH SERVICES
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-1651
Practice Address - Country:US
Practice Address - Phone:850-477-0401
Practice Address - Fax:850-477-2183
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2040072363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305657100Medicaid
FLY032FOtherBSFL
FLU1178XMedicare PIN
FL305657100Medicaid