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General NPI Number Information
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NPI Number | 1699307165
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Entity Type | Individual
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Provider Name | DEBRA GLEASON
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Gender | Female
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Dates
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Enumeration Date | 02/12/2020
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 500 KIRTS BLVD STE 100
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City | TROY
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State | MI
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Zip | 48084-4135
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Country | US
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Telephone | 248-824-6060
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 40412
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City | BELFAST
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State | ME
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Zip | 04915-1255
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Country | US
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Telephone | 248-824-6000
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Fax | 855-618-6655
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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 | 3014342
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License Number State | KY
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