MEDICARE: MS. DEBORAH LYNN POLLAK NP-C

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	363LP2300X	Primary Care Nurse Practitioner	670289	TX
2	363LP2300X	Primary Care Nurse Practitioner	28172466A	IN

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	:	1447252499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH LYNN POLLAK NP-C

Provider Business Mailing Address
First Line	:	3590 HUNTERS GLEN RD
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79605-4922
Country	:	US
Telephone Number	:	325-695-7433
Fax Number	:	325-673-9989

Provider Business Practice Location Address
First Line	:	3116 N 1ST ST
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79603-7004
Country	:	US
Telephone Number	:	325-673-9987
Fax Number	:	325-673-9989

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	11/02/2015

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