Debbout, Mary J

Debbout, Mary J is an individual health care provider with primary practice located at 744 S Webster Ave , Green Bay WI 54305-3400. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Debbout, Mary J can be contacted via phone (920) 433-5582.

Contact Information

Primary practice address
744 S Webster Ave Green Bay WI 54305-3400
Phone: (920) 433-5582
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 68464-30 Wisconsin

Profile Details

NPI number 1619004025
LBN Legal business name Debbout, Mary J
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2007
Last updated Jun 25th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619004025 NPPES
Wisconsin MEDICAID 43309200

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