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General NPI Number Information
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NPI Number | 1760842330
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Entity Type | Individual
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Provider Name | DEBRA DEE MUNN APRN-BC
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Gender | Female
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Dates
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Enumeration Date | 02/25/2016
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Last Update Date | 02/25/2016
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Provider Practice Location Address
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Address Line | 481 JAMES E. HANNAH DRIVE
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City | SOUTH SHORE
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State | KY
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Zip | 41175-9598
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Country | US
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Telephone | 606-932-4334
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Fax |
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Provider Business Mailing Address
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Address Line | 297 STATE ROUTE 3117
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City | SOUTH SHORE
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State | KY
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Zip | 41175-9598
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Country | US
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Telephone | 606-923-8191
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3001904
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License Number State | KY
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