MEDICARE: DEBRA A LITKE RN/NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	212645	MA

General Provider Information

NPI Number	:	1578610945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA A LITKE RN/NP

Provider Business Mailing Address
First Line	:	941 GREAT PLAIN AVE
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02492-3031
Country	:	US
Telephone Number	:	339-777-5554
Fax Number	:

Provider Business Practice Location Address
First Line	:	941 GREAT PLAIN AVE
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02492-3031
Country	:	US
Telephone Number	:	339-777-5554
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	10/09/2024

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