Healthcare Provider Details

I. General information

NPI: 1295862001
Provider Name (Legal Business Name): DEBRA ANN RILL CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 FAR HILLS AVE STE 200
DAYTON OH
45429-2203
US

IV. Provider business mailing address

PO BOX 933432
CLEVELAND OH
44193-0039
US

V. Phone/Fax

Practice location:
  • Phone: 937-436-2866
  • Fax: 937-436-1468
Mailing address:
  • Phone: 937-641-5072
  • Fax: 937-641-6129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN.CNP.02546
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: