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General NPI Number Information
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NPI Number | 1386931210
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Entity Type | Individual
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Provider Name | DEBORAH ANN BOMFORD ARNP
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Gender | Female
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 12/30/2021
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Provider Practice Location Address
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Address Line | 22 CENTURY BLVD STE 200
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City | NASHVILLE
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State | TN
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Zip | 37214-3702
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Country | US
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Telephone | 877-714-1370
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Fax |
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Provider Business Mailing Address
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Address Line | 3791 WOODS WALK BLVD
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City | LAKE WORTH
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State | FL
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Zip | 33467-2361
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Country | US
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Telephone | 561-707-5767
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3006262
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License Number State | FL
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