Healthcare Provider Details

I. General information

NPI: 1669494498
Provider Name (Legal Business Name): DEBRAN LYNN HARMON-O'CONNOR MSN, CRNA, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2165 HERSCHEL ST
JACKSONVILLE FL
32204-3819
US

IV. Provider business mailing address

MSC#662 PO BOX 830529
BIRMINGHAM AL
35283-0529
US

V. Phone/Fax

Practice location:
  • Phone: 904-387-4030
  • Fax: 904-381-9808
Mailing address:
  • Phone: 844-211-1592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2804752
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2804752
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: