Provider Demographics
NPI:1366719205
Name:JUR, DEBRA JANE (FNP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:JANE
Last Name:JUR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6325 E TANQUE VERDE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3808
Mailing Address - Country:US
Mailing Address - Phone:520-795-5830
Mailing Address - Fax:520-885-4469
Practice Address - Street 1:6325 E TANQUE VERDE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3808
Practice Address - Country:US
Practice Address - Phone:520-795-5830
Practice Address - Fax:520-885-4469
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4162174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ21925Medicare PIN
AZZ65444Medicare PIN
AZZ70462Medicare PIN
AZ013714U30Medicare PIN
AZZ113176Medicare PIN
AZZ66004Medicare PIN
AZZ21923Medicare PIN
AZ144042Medicare PIN
Z21921Medicare PIN
AZZ80094Medicare PIN
AZZ21922Medicare PIN
AZF31369Medicare UPIN
AZP44242Medicare UPIN
AZZ70463Medicare PIN