Provider Demographics
NPI:1457690182
Name:LAURENCE, DEBRA LYNN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:LYNN
Last Name:LAURENCE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 JEFFERSON OVAL APT B
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-1304
Mailing Address - Country:US
Mailing Address - Phone:914-886-2932
Mailing Address - Fax:
Practice Address - Street 1:53 JEFFERSON OVAL APT B
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-1304
Practice Address - Country:US
Practice Address - Phone:914-886-2932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232535-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse