MEDICARE: DEBRA SOCKYMA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant		AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265559579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA SOCKYMA

Provider Business Mailing Address
First Line	:	PO BOX 13
Second Line	:
City	:	KYKOTSMOVI
State	:	AZ
Zip	:	86039-0013
Country	:	US
Telephone Number	:	928-734-0250
Fax Number	:

Provider Business Practice Location Address
First Line	:	ONE EIGHTH OF A MILE FROM JCT HWY 264 IN KYKOTSMOVI
Second Line	:	VILLAGE ROCK HOUSE BY MENONITE CHURCH
City	:	KYKOTSMOVI
State	:	AZ
Zip	:	86039
Country	:	US
Telephone Number	:	928-734-6614
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	07/09/2007

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Directions to “ DEBRA SOCKYMA ” Practice Location

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