Provider Demographics
NPI:1457803272
Name:KRISON, DEBRA A (APRN)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:A
Last Name:KRISON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:A
Other - Last Name:DOWD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-382-4972
Mailing Address - Fax:603-382-9305
Practice Address - Street 1:24 PLAISTOW RD STE 2
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2851
Practice Address - Country:US
Practice Address - Phone:603-382-4972
Practice Address - Fax:603-382-9305
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH047935-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3110518Medicaid