Individual
PAMELA R DEBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2514 S 102ND ST STE 160, WEST ALLIS, WI 53227-2142
(414) 225-0304
Mailing address
6860 DALLAS PKWY, STE 550, PLANO, TX 75024-4252
(414) 688-5751
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
440933
WI
363LA2100X
Acute Care Nurse Practitioner
4409
WI
Other
Enumeration date
06/06/2011
Last updated
01/04/2017
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