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General NPI Number Information
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NPI Number | 1184190878
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Entity Type | Individual
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Provider Name | DEBRA GORAL
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Gender | Female
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Dates
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Enumeration Date | 10/19/2018
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 7223 LEE DEFOREST DR
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City | COLUMBIA
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State | MD
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Zip | 21046-3236
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Country | US
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Telephone | 443-430-8312
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Fax |
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Provider Business Mailing Address
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Address Line | 1317 PARTRIDGE CT
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City | OSHKOSH
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State | WI
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Zip | 54904-8840
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Country | US
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Telephone | 623-226-9429
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN175069
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License Number State | AZ
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