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General NPI Number Information
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NPI Number | 1912914078
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Entity Type | Individual
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Provider Name | DEBRA A HENDREN FNP
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Gender | Female
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 07/28/2016
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Provider Practice Location Address
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Address Line | 1344 22ND ST S
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City | SAINT PETERSBURG
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State | FL
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Zip | 33712-2744
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Country | US
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Telephone | 901-481-4642
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Fax | 727-824-8150
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Provider Business Mailing Address
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Address Line | PO BOX 10549
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City | SAINT PETERSBURG
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State | FL
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Zip | 33733-0549
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Country | US
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Telephone | 727-824-8181
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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 | ARNP9427949
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License Number State | FL
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