Provider Demographics
NPI:1952829749
Name:MILLHAUSEN, DEBBRA LYNN (CRNP)
Entity Type:Individual
Prefix:
First Name:DEBBRA
Middle Name:LYNN
Last Name:MILLHAUSEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DEBBRA
Other - Middle Name:LYNN
Other - Last Name:KANYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:228 SAINT CHARLES WAY STE 200
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4661
Practice Address - Country:US
Practice Address - Phone:717-851-5503
Practice Address - Fax:717-851-5507
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018352363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPENDINGMedicaid