Provider Demographics
NPI:1710239165
Name:DEBONE, DENISE (ARNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:DEBONE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 HIDDEN VALLEY DR
Mailing Address - Street 2:#9101
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1394
Mailing Address - Country:US
Mailing Address - Phone:954-540-8366
Mailing Address - Fax:
Practice Address - Street 1:4426 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-1341
Practice Address - Country:US
Practice Address - Phone:512-492-5640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9194128363L00000X
TXAP125986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner