Provider Demographics
NPI:1790877751
Name:BORMANIS, DEBRA (NP-C, MBA-HCM)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:BORMANIS
Suffix:
Gender:F
Credentials:NP-C, MBA-HCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2767 JANITELL RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4102
Mailing Address - Country:US
Mailing Address - Phone:719-365-2888
Mailing Address - Fax:970-365-1577
Practice Address - Street 1:2767 JANITELL RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4102
Practice Address - Country:US
Practice Address - Phone:719-365-2888
Practice Address - Fax:970-365-1577
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0109212163W00000X
COAPN.0002968-NP363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily