Provider Demographics
NPI:1306619085
Name:HARPER-KIESLING, DEBRA NICOLE (NP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:NICOLE
Last Name:HARPER-KIESLING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:959 FELSPAR ST APT 1E
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-2723
Mailing Address - Country:US
Mailing Address - Phone:610-563-0053
Mailing Address - Fax:
Practice Address - Street 1:959 FELSPAR ST APT 1E
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-2723
Practice Address - Country:US
Practice Address - Phone:610-563-0053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027210363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology