Provider Demographics
NPI:1306241187
Name:NEUBAUER, DEBRA ELLEN (FNP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ELLEN
Last Name:NEUBAUER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:ELLEN
Other - Last Name:STEVERMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:951 TRANSPORT DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-8434
Mailing Address - Country:US
Mailing Address - Phone:219-477-6082
Mailing Address - Fax:219-465-9502
Practice Address - Street 1:420 W 4TH ST
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544-1948
Practice Address - Country:US
Practice Address - Phone:574-307-7673
Practice Address - Fax:574-307-7692
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71005267A363LF0000X
TX566439163W00000X
IN28159543A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse