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General NPI Number Information
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NPI Number | 1164511341
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Entity Type | Individual
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Provider Name | DEBRA BRISTOL APRN
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 1250 S CLEARVIEW AVE 100
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City | MESA
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State | AZ
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Zip | 85209-3378
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Country | US
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Telephone | 480-423-4670
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Fax | 480-654-2922
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Provider Business Mailing Address
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Address Line | 976 MOUNTAIN CITY HWY
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City | ELKO
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State | NV
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Zip | 89801-2728
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Country | US
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Telephone | 775-777-7587
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Fax | 775-738-9584
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN00276
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License Number State | NV
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