Provider Demographics
NPI:1851450233
Name:BOND, DEBRA CARLSON (APRN)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:CARLSON
Last Name:BOND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 BUCKLAND DR
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-4147
Mailing Address - Country:US
Mailing Address - Phone:203-271-2384
Mailing Address - Fax:
Practice Address - Street 1:10 MAIN ST
Practice Address - Street 2:CHESHIRE ACADEMY HEALTH CENTER
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2403
Practice Address - Country:US
Practice Address - Phone:203-439-7280
Practice Address - Fax:203-439-7113
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000969363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics