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General NPI Number Information
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NPI Number | 1831170711
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Entity Type | Individual
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Provider Name | DEBRA GAIL MAMMEN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3200 N DOBSON RD SUITE F3
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City | CHANDLER
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State | AZ
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Zip | 85224-9601
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Country | US
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Telephone | 480-838-4277
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Fax | 480-777-2331
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Provider Business Mailing Address
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Address Line | 931 W SHERRI DR
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City | GILBERT
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State | AZ
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Zip | 85233-7935
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Country | US
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Telephone | 480-518-1488
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Fax | 480-777-2331
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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 | AZ2171
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License Number State | AZ
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