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General NPI Number Information
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NPI Number | 1881649382
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Entity Type | Individual
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Provider Name | DEBORAH JEAN GOETTELMAN M.S., BC-ARNP, CDE
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Gender | Female
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | BAY PINES VA HEALTHCARE SYSTEM 10000 BAY PINES BOULEVARD
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City | ST. PETERSBURG
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State | FL
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Zip | 33744
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Country | US
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Telephone | 727-398-6661
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Fax | 727-319-1052
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Provider Business Mailing Address
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Address Line | 11230 KAPOK GRAND CIR
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City | MADEIRA BEACH
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State | FL
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Zip | 33708-3016
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Country | US
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Telephone | 727-320-0859
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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 | 1181602C
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License Number State | FL
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