MEDICARE: MS. DEBORAH BALL FALLON RNP

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	363LF0000X	Family Nurse Practitioner	NPF9761	CA

General Provider Information

NPI Number	:	1639243561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH BALL FALLON RNP

Provider Business Mailing Address
First Line	:	PO BOX 2424
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95611-2424
Country	:	US
Telephone Number	:	916-425-9351
Fax Number	:

Provider Business Practice Location Address
First Line	:	3501 PALMER DR
Second Line	:	SUITE 204
City	:	CAMERON PARK
State	:	CA
Zip	:	95682-8276
Country	:	US
Telephone Number	:	530-672-1311
Fax Number	:	530-672-1335

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	07/08/2007

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