Provider Demographics
NPI:1477856557
Name:BURLEIGH, DEBRA JEAN (RN)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:JEAN
Last Name:BURLEIGH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:JEAN
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:167 DOUGLAS DR
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-2907
Mailing Address - Country:US
Mailing Address - Phone:614-428-1425
Mailing Address - Fax:
Practice Address - Street 1:75521 LEMAY RD.
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OH
Practice Address - Zip Code:45710
Practice Address - Country:US
Practice Address - Phone:740-698-0561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-13
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN158738163WH0200X
374U00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion