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NPI Code Detail

MEDICARE: DEBRA A NIGBUR PA-C

MEDICARE: DEBRA A NIGBUR PA-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
1363A00000XPhysician Assistant5732AZ
2363AM0700XMedical Physician Assistant5732AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00888757OTHERMNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629040969
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA A NIGBUR PA-C
Provider Business Mailing Address
First Line : 6470 S HIGLEY RD
Second Line :
City : GILBERT
State : AZ
Zip : 85298-4341
Country : US
Telephone Number : 480-809-2409
Fax Number :
Provider Business Practice Location Address
First Line : 6470 S HIGLEY RD
Second Line :
City : GILBERT
State : AZ
Zip : 85298-4341
Country : US
Telephone Number : 480-809-2409
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 11/04/2019

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