=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396955597
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEBORAH DAVIS PULLEN APRN-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2007
-----------------------------------------------------
Last Update Date | 06/23/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 927 RALEY ST
-----------------------------------------------------
City | GADSDEN
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35903-2027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-439-6384
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 112 HIDDEN CIR
-----------------------------------------------------
City | RAINBOW CITY
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35906-8716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 125-644-2040
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 1-093236
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------