Provider Demographics
NPI:1639673486
Name:MCKINNEY, DEBRA L (NSN APRN FNP-C)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:L
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:NSN APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4421 BECK AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-9440
Mailing Address - Country:US
Mailing Address - Phone:330-871-8468
Mailing Address - Fax:
Practice Address - Street 1:1260 INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-1812
Practice Address - Country:US
Practice Address - Phone:234-312-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAPRN.CNP.022325OtherOHIO BOARD OF NURSING LISCENSE NUMBER