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NPI Code Detail

MEDICARE: MRS. DEBORAH ANNE PANCHELLA ARNP

MEDICARE: MRS. DEBORAH ANNE PANCHELLA ARNP
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
1363LX0001XObstetrics & Gynecology Nurse PractitionerARNP849572FL

General Provider Information

NPI Number : 1871569806
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBORAH ANNE PANCHELLA ARNP
Provider Business Mailing Address
First Line : 301 S LEMON ST
Second Line : PO BOX 847
City : BUNNELL
State : FL
Zip : 32110-6212
Country : US
Telephone Number : 386-437-7350
Fax Number : 386-437-8207
Provider Business Practice Location Address
First Line : 301 S LEMON ST
Second Line :
City : BUNNELL
State : FL
Zip : 32110-6212
Country : US
Telephone Number : 386-437-7350
Fax Number : 386-437-8207
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2006
Last Update Date : 07/08/2007

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