Provider Demographics
NPI:1396955597
Name:PULLEN, DEBORAH DAVIS (APRN-BC)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:DAVIS
Last Name:PULLEN
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 HIDDEN CIR
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-8716
Mailing Address - Country:US
Mailing Address - Phone:125-644-2040
Mailing Address - Fax:
Practice Address - Street 1:927 RALEY ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-2027
Practice Address - Country:US
Practice Address - Phone:256-439-6384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-093236363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL110431Medicaid
AL110427Medicaid
AL102I506525Medicare PIN