Provider Demographics
NPI:1811932098
Name:CAIN, DEBRA SUE (APRN)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:SUE
Last Name:CAIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 HOLLY ST.
Mailing Address - Street 2:
Mailing Address - City:HOLLY HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29059-1250
Mailing Address - Country:US
Mailing Address - Phone:803-496-3324
Mailing Address - Fax:803-496-9653
Practice Address - Street 1:932 HOLLY STREET
Practice Address - Street 2:
Practice Address - City:HOLLY HILL
Practice Address - State:SC
Practice Address - Zip Code:29059-1250
Practice Address - Country:US
Practice Address - Phone:803-496-3324
Practice Address - Fax:803-496-9653
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC104363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner