Healthcare Provider Details
I. General information
NPI: 1245330976
Provider Name (Legal Business Name): DEBRA LYNN TOPP CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1507 CEDAR RIDGE RD
NORFOLK NE
68701-3117
US
IV. Provider business mailing address
1507 CEDAR RIDGE RD
NORFOLK NE
68701-3117
US
V. Phone/Fax
- Phone: 402-649-0393
- Fax: 402-371-1664
- Phone: 402-649-0393
- Fax: 402-371-1664
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | 100349 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: