Provider Demographics
NPI:1588956015
Name:HANCE, DEBRA LYNN (RN)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN
Last Name:HANCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:STAR LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:13690-3138
Mailing Address - Country:US
Mailing Address - Phone:315-848-2573
Mailing Address - Fax:
Practice Address - Street 1:297 LAKE RD
Practice Address - Street 2:
Practice Address - City:STAR LAKE
Practice Address - State:NY
Practice Address - Zip Code:13690-3138
Practice Address - Country:US
Practice Address - Phone:315-848-2573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY473459-1163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health