Provider Demographics
NPI:1134218340
Name:MACDONALD, DEBRA LYNN (RN)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:LYNN
Last Name:MACDONALD
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 1:5621 S SPINNAKER RD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-2138
Mailing Address - Country:US
Mailing Address - Phone:480-838-7730
Mailing Address - Fax:
Practice Address - Street 1:1025 S BECK AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-5399
Practice Address - Country:US
Practice Address - Phone:480-966-7114
Practice Address - Fax:480-829-6178
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN037707163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool