Provider Demographics
NPI:1306062542
Name:UNCAPHER, DEBRA J (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:J
Last Name:UNCAPHER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 W MARKET ST STE 108
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6005
Mailing Address - Country:US
Mailing Address - Phone:423-833-0033
Mailing Address - Fax:423-833-0031
Practice Address - Street 1:1409 W MARKET ST STE 108
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6005
Practice Address - Country:US
Practice Address - Phone:423-833-0033
Practice Address - Fax:423-833-0031
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN12680207Q00000X, 363LF0000X
TN0000060274363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3341401Medicaid