Basic Information
| Provider Information | |||||||||
| NPI: | 1619001492 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STAMP | ||||||||
| FirstName: | DEBRA | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 81 W ESPERANZA BLVD | ||||||||
| Address2: | STE 201 | ||||||||
| City: | GREEN VALLEY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 856142667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206254401 | ||||||||
| FaxNumber: | 5206258504 | ||||||||
| Practice Location | |||||||||
| Address1: | 15921 W AJO WAY | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206253691 | ||||||||
| FaxNumber: | 5206252335 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2007 | ||||||||
| LastUpdateDate: | 01/12/2009 | ||||||||
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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 | 363L00000X | RN032304 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.