Provider Demographics
NPI:1922084300
Name:BRAKEFIELD, DEBRA A CALDWELL (APRN)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:A CALDWELL
Last Name:BRAKEFIELD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:A
Other - Last Name:CALDWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1307 S PINE AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-6543
Mailing Address - Country:US
Mailing Address - Phone:352-368-2238
Mailing Address - Fax:352-368-5042
Practice Address - Street 1:1307 S PINE AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-368-2238
Practice Address - Fax:352-368-5042
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN972032363LW0102X, 363LX0001X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL302031200Medicaid
FL302031200Medicaid
FLS81441Medicare UPIN