Healthcare Provider Details

I. General information

NPI: 1164649794
Provider Name (Legal Business Name): DEBRA LYNN MATHIS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS DEBRA LYNN CROWSON

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 GEORGIA AVENUE
BAKER FL
32531-2605
US

IV. Provider business mailing address

2804 REMINGTON GREEN CIR STE 2
TALLAHASSEE FL
32308-1550
US

V. Phone/Fax

Practice location:
  • Phone: 850-537-2700
  • Fax: 850-537-2702
Mailing address:
  • Phone: 850-385-4494
  • Fax: 850-298-6054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 1427202
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: