Provider Demographics
NPI:1720882582
Name:ANDERSON, DEBRA ANN (RN, BSN, FNP-S)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ANN
Last Name:ANDERSON
Suffix:
Gender:
Credentials:RN, BSN, FNP-S
Other - Prefix:PROF
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 255433
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95865-5433
Mailing Address - Country:US
Mailing Address - Phone:703-786-1661
Mailing Address - Fax:
Practice Address - Street 1:1111 COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-1936
Practice Address - Country:US
Practice Address - Phone:703-786-1661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95170829390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program