Individual
DEBRA ROUSE HABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MS, AGNP-C, DNP
Contact information
Practice address
755 S GRAPEVINE LOOP, BENSON, AZ 85602-7430
(520) 490-1456
Mailing address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(520) 224-4537
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AP4654
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
729716
—
AZ
Enumeration date
07/15/2012
Last updated
06/22/2020
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