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NPI Code Detail

MEDICARE: DEBORAH E ECKLES RN

MEDICARE: DEBORAH E ECKLES RN
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
1163W00000XRegistered Nurse382687CA

General Provider Information

NPI Number : 1306952239
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH E ECKLES RN
Provider Business Mailing Address
First Line : 1509 N B CT
Second Line :
City : LOMPOC
State : CA
Zip : 93436-3479
Country : US
Telephone Number : 805-736-1635
Fax Number :
Provider Business Practice Location Address
First Line : 90 VIA JUANA RD
Second Line :
City : SANTA YNEZ
State : CA
Zip : 93460-9679
Country : US
Telephone Number : 805-688-7070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2006
Last Update Date : 07/08/2007

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Directions to “ DEBORAH E ECKLES RN” Practice Location

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