Provider Demographics
NPI:1538343371
Name:GRESS, DEBRA LYNN (CRNP)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:LYNN
Last Name:GRESS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6321 ROUTE 30 FL 2
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-9703
Mailing Address - Country:US
Mailing Address - Phone:724-671-1750
Mailing Address - Fax:724-523-7726
Practice Address - Street 1:6321 ROUTE 30 FL 2
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-9703
Practice Address - Country:US
Practice Address - Phone:724-671-1750
Practice Address - Fax:724-523-7726
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA296112L163W00000X
PAVP005072B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1033334800001Medicaid
PA14011979OtherCAQH
PA175295OtherBLUE SHIELD
PA022619Medicare PIN