Individual
DEBBIE A SEBASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(513) 523-0022
(513) 523-0022
Mailing address
PO BOX 12749, COVINGTON, KY 41012-0749
(513) 523-0022
(513) 523-0022
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1108168
KY
174400000X
Specialist
RN223077
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
045245
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000318542
ANTHEM BCBS
OH
01
—
000000375727
ANTHEM
—
05
—
0224948
—
OH
05
—
74010364
—
KY
01
—
P00098202
RAILROAD MEDICARE
OH
Enumeration date
08/24/2005
Last updated
04/09/2008
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