Healthcare Provider Details

I. General information

NPI: 1518204411
Provider Name (Legal Business Name): DEBORAH COUPLAND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH ANNE COUPLAND-PORTER APRN

II. Dates (important events)

Enumeration Date: 01/11/2013
Last Update Date: 03/24/2022
Certification Date: 03/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6272 LAKE OSPREY DR
LAKEWOOD RANCH FL
34240-8425
US

IV. Provider business mailing address

6272 LAKE OSPREY DR
LAKEWOOD RANCH FL
34240-8425
US

V. Phone/Fax

Practice location:
  • Phone: 941-666-8757
  • Fax: 941-348-1421
Mailing address:
  • Phone: 941-666-8757
  • Fax: 941-348-1421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 2826832
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: