Healthcare Provider Details

I. General information

NPI: 1457319683
Provider Name (Legal Business Name): DEBBIE ALICE YORK FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 BREMO RD
RICHMOND VA
23226-2443
US

IV. Provider business mailing address

3804 KENSINGTON AVE
RICHMOND VA
23221-2010
US

V. Phone/Fax

Practice location:
  • Phone: 804-282-5236
  • Fax: 804-282-5547
Mailing address:
  • Phone: 804-349-6400
  • Fax: 804-282-5547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number0017137911
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: