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General NPI Number Information
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NPI Number | 1447217815
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Entity Type | Individual
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Provider Name | DEBRA PECKA MALINA CRNA
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Gender | Female
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 9614 OLD JOHNNYCAKE RIDGE RD
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City | CONCORD TOWNSHIP
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State | OH
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Zip | 44060-6521
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Country | US
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Telephone | 440-205-1225
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Fax | 440-205-1275
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Provider Business Mailing Address
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Address Line | PO BOX 381468
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City | GERMANTOWN
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State | TN
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Zip | 38183-1468
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Country | US
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Telephone |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN.CRNA.0020672
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License Number State | OH
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