Individual
DEBRA RAE LESLIE AUGUSTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
385 CANYON DIABLO RD, SEDONA, AZ 86351-9196
(928) 310-1706
(928) 554-4384
Mailing address
385 CANYON DIABLO RD, SEDONA, AZ 86351-9196
(928) 310-1706
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP2872
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN148592
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
148592
AZ RN LICENSE
AZ
05
—
241905
—
OR
01
—
AP2872
AZ NP CERTIFICATE
AZ
Enumeration date
11/15/2006
Last updated
02/28/2014
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