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Individual

RUSELLE SUE DEBONIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1015 S HACKETT RD, WATERLOO, IA 50701
(319) 274-1000
(319) 292-6526
Mailing address
1015 S HACKETT RD, WATERLOO, IA 50701
(319) 274-1000
(319) 292-6526

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A059613
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1275511230
IA
01
29120
BC/BS
IA
01
42137207611
JOHN DEERE
IA
01
P00819155
RR MEDICARE
IA
Enumeration date
01/09/2006
Last updated
06/24/2010
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