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Individual
DEBBI L STAATS
Active
Individual
DEBBI L STAATS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00645
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227616
—
OR
01
—
383846
MEDICARE RHC PROVIDER NUM
OR
01
—
C91331
SUPERVISING MD'S UPIN
OR
Enumeration date
06/01/2006
Last updated
11/19/2008
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