# DEBRA FORMO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1093564197
- **Gender:** F
- **Credential:** RN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | RN569424 | PA | Yes |
| 163WP0809X | Adult Psychiatric/Mental Health Registered Nurse | RN569424 | PA | — |

## Other

- **Enumeration date:** 05/13/2024
- **Last updated:** 05/13/2024