Provider Demographics
NPI:1912942186
Name:CHERRY-LEDERMAN, DEBRA ANN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:CHERRY-LEDERMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:CHERRY-LEDERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:1025 SW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0900
Mailing Address - Country:US
Mailing Address - Phone:352-732-6599
Mailing Address - Fax:352-732-4816
Practice Address - Street 1:1025 SW 1ST AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0900
Practice Address - Country:US
Practice Address - Phone:352-732-6599
Practice Address - Fax:352-732-4816
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0064869363LA2200X
FLARNP9377208363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200041370AMedicaid
FL010924600Medicaid
OK200041370AMedicaid