Healthcare Provider Details

I. General information

NPI: 1427174648
Provider Name (Legal Business Name): DEBORAH L NUTTING RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 S SEACREST BLVD #200
BOYNTON BEACH FL
33435-7960
US

IV. Provider business mailing address

2800 S SEACREST BLVD #200
BOYNTON BEACH FL
33435-7960
US

V. Phone/Fax

Practice location:
  • Phone: 561-736-8303
  • Fax:
Mailing address:
  • Phone: 561-736-8303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN2628732
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: