Provider Demographics
NPI:1972272771
Name:CHUA, DEBBIE-MARIE (BSN RN)
Entity Type:Individual
Prefix:
First Name:DEBBIE-MARIE
Middle Name:
Last Name:CHUA
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22096 BEDFORD VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-2311
Mailing Address - Country:US
Mailing Address - Phone:313-415-9082
Mailing Address - Fax:
Practice Address - Street 1:2525 DEMILLE BLVD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3461
Practice Address - Country:US
Practice Address - Phone:810-245-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704237025163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA