Individual
JACOB R DEBONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1293 E PARKDALE AVE, MANISTEE, MI 49660-8904
(231) 398-1840
(231) 398-1835
Mailing address
1345 E. PARKDALE, MANISTEE, MI 49660
(231) 398-1735
(231) 398-1736
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704285441
MI
Other
Enumeration date
01/08/2019
Last updated
12/01/2022
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