Provider Demographics
NPI:1841740545
Name:BENCE, DEBRA
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:BENCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4259 CASKIE PL
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34604-5828
Mailing Address - Country:US
Mailing Address - Phone:813-992-6829
Mailing Address - Fax:
Practice Address - Street 1:4259 CASKIE PLACE
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FLORIDA
Practice Address - Zip Code:34604
Practice Address - Country:UM
Practice Address - Phone:813-992-6829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI107900-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse