Provider Demographics
NPI:1801855432
Name:HUSSEY, DEBRA A (NP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:HUSSEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:200 MILL RD
Practice Address - Street 2:SUITE 190
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-5252
Practice Address - Country:US
Practice Address - Phone:508-973-0857
Practice Address - Fax:508-973-2176
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213428363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110079545AMedicaid
MA110079545AMedicaid
RI2239OtherBCBS-RHODE ISLAND
MANP1718Medicare PIN
MA500015250OtherRAILROAD MEDICARE