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General NPI Number Information
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NPI Number | 1699855031
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Entity Type | Individual
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Provider Name | DEBRA JEAN HULFORD NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 16450 104TH AVE SUITE #101
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City | ORLAND PARK
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State | IL
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Zip | 60467-5441
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Country | US
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Telephone | 708-349-0070
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Fax | 708-349-0077
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Provider Business Mailing Address
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Address Line | 17910 HOOD AVE
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City | HOMEWOOD
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State | IL
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Zip | 60430-1911
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Country | US
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Telephone | 708-224-9479
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209005607
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License Number State | IL
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