Provider Demographics
NPI:1821305897
Name:RINER, DEBRA L (RN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:L
Last Name:RINER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24315 SKI RD
Mailing Address - Street 2:
Mailing Address - City:CHUGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99567-6248
Mailing Address - Country:US
Mailing Address - Phone:907-688-4100
Mailing Address - Fax:
Practice Address - Street 1:24315 SKI RD
Practice Address - Street 2:
Practice Address - City:CHUGIAK
Practice Address - State:AK
Practice Address - Zip Code:99567-6248
Practice Address - Country:US
Practice Address - Phone:907-688-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK17061163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse