MEDICARE: MRS. DEBRA ANN DOERFLER R.N.

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	163WS0200X	School Registered Nurse	RN141758	AZ

General Provider Information

NPI Number	:	1962520650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBRA ANN DOERFLER R.N.

Provider Business Mailing Address
First Line	:	1025 N COUNTRY CLUB DR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85201-3307
Country	:	US
Telephone Number	:	480-472-6678
Fax Number	:	480-472-6698

Provider Business Practice Location Address
First Line	:	1350 S LINDSAY RD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85204-6229
Country	:	US
Telephone Number	:	480-472-6678
Fax Number	:	480-472-6698

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	07/08/2007

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