Basic Information
| Provider Information | |||||||||
| NPI: | 1063660546 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUTZ | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | GAY | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 844 OLD TUNNEL RD | ||||||||
| Address2: | |||||||||
| City: | GRASS VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959458524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302749762 | ||||||||
| FaxNumber: | 5302737255 | ||||||||
| Practice Location | |||||||||
| Address1: | 887 US HIGHWAY 84 W | ||||||||
| Address2: | |||||||||
| City: | TEAGUE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 758605141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2547395090 | ||||||||
| FaxNumber: | 2547395666 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2008 | ||||||||
| LastUpdateDate: | 06/21/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | 95001465 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
No ID Information.