Provider Demographics
NPI:1861274532
Name:NOLAND, DEBRA ANN (PMHNP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:NOLAND
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:BELANGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:181 MAIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6918
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:181 MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-6918
Practice Address - Country:US
Practice Address - Phone:516-430-0867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY404565363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health