Basic Information
| Provider Information | |||||||||
| NPI: | 1275529315 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EISEN | ||||||||
| FirstName: | DEBRA | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 277219 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303847219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009191190 | ||||||||
| FaxNumber: | 7067372272 | ||||||||
| Practice Location | |||||||||
| Address1: | 6500 66TH ST | ||||||||
| Address2: | |||||||||
| City: | PINELLAS PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337815030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273471286 | ||||||||
| FaxNumber: | 7278281460 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2005 | ||||||||
| LastUpdateDate: | 08/08/2007 | ||||||||
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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 | 367500000X | ARNP 2106842 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.