Provider Demographics
NPI:1952616385
Name:CARNEGIE, DEBRA (MS,RD,LD/N,CDE)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:
Last Name:CARNEGIE
Suffix:
Gender:F
Credentials:MS,RD,LD/N,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10009 NW 62ND LN
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-6800
Mailing Address - Country:US
Mailing Address - Phone:352-222-2707
Mailing Address - Fax:352-381-8294
Practice Address - Street 1:10009 NW 62ND LN
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-6800
Practice Address - Country:US
Practice Address - Phone:352-222-2707
Practice Address - Fax:352-381-8294
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND2768133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLER446YMedicare PIN