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General NPI Number Information
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NPI Number | 1467598151
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Entity Type | Individual
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Provider Name | DEBRA LYN HERNDON MSN, FNP-BC, CRNFA
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Gender | Female
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 12/10/2010
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Provider Practice Location Address
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Address Line | 2175 ROSALINE AVE
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City | REDDING
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State | CA
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Zip | 96001-2509
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Country | US
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Telephone | 530-225-6000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 496084
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City | REDDING
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State | CA
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Zip | 96049-6084
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Country | US
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Telephone | 530-241-0473
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Fax | 530-241-5377
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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 | 20376
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 498434
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 095006510RN
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License Number State | OR
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