Provider Demographics
NPI:1740716604
Name:KALISH, DEBORAH ANNE (RN)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANNE
Last Name:KALISH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 W PARKER RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8185
Mailing Address - Country:US
Mailing Address - Phone:972-981-4225
Mailing Address - Fax:972-981-4226
Practice Address - Street 1:6200 W PARKER RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8185
Practice Address - Country:US
Practice Address - Phone:972-981-4225
Practice Address - Fax:972-981-4226
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX810124163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator