Healthcare Provider Details

I. General information

NPI: 1851727275
Provider Name (Legal Business Name): DEBBIE LISA BRACHMAN FNP, MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH LISA BRACHMAN FNP, MSN, RN

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 W SOUTHERN AVE STE E
MESA AZ
85210-5018
US

IV. Provider business mailing address

PO BOX 2447
ORCUTT CA
93457-2447
US

V. Phone/Fax

Practice location:
  • Phone: 602-633-4069
  • Fax:
Mailing address:
  • Phone: 602-633-4069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number171226
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number766383
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number766383
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95000143
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number224391
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: