Provider Demographics
NPI:1730246026
Name:MARCINCZYK, DEBRA ANN (CRNA)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:MARCINCZYK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:A
Other - Last Name:HEFFNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:4587 SOUTHERN PINES DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-4710
Mailing Address - Country:US
Mailing Address - Phone:910-616-9931
Mailing Address - Fax:
Practice Address - Street 1:816 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 2G
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6010
Practice Address - Country:US
Practice Address - Phone:757-470-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170407367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered