Healthcare Provider Details

I. General information

NPI: 1952877144
Provider Name (Legal Business Name): DEBRA PAINTER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2018
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 WASHINGTON AVE
VINCENNES IN
47591-2240
US

IV. Provider business mailing address

PO BOX 556
VINCENNES IN
47591-0556
US

V. Phone/Fax

Practice location:
  • Phone: 812-494-7500
  • Fax: 812-494-7600
Mailing address:
  • Phone: 812-494-9501
  • Fax: 812-494-9502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number28170283A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71008590A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: