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NPI Code Detail

MEDICARE: DEBRA EBERSOLE KAUFFMAN FNP

MEDICARE: DEBRA EBERSOLE KAUFFMAN FNP
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
1163W00000XRegistered Nurse411613CA
2363L00000XNurse PractitionerNP8684CA

General Provider Information

NPI Number : 1932185246
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA EBERSOLE KAUFFMAN FNP
Provider Business Mailing Address
First Line : 3400 DATA DR
Second Line :
City : RANCHO CORDOVA
State : CA
Zip : 95670-7956
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1700 PRAIRIE CITY RD
Second Line :
City : FOLSOM
State : CA
Zip : 95630-9594
Country : US
Telephone Number : 916-351-4800
Fax Number : 916-351-4899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 05/11/2018

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