Provider Demographics
NPI:1104811363
Name:ZIEGLER-BEZAIRE, DEBRA LYNN (NP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN
Last Name:ZIEGLER-BEZAIRE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:LYNN
Other - Last Name:BEZAIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:43800 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1136
Mailing Address - Country:US
Mailing Address - Phone:800-848-0202
Mailing Address - Fax:586-226-6949
Practice Address - Street 1:22201 MOROSS RD
Practice Address - Street 2:270
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2169
Practice Address - Country:US
Practice Address - Phone:313-343-3481
Practice Address - Fax:313-343-7937
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704141114163WR1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR1000XNursing Service ProvidersRegistered NurseReproductive Endocrinology/Infertility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4583466Medicaid