Provider Demographics
NPI:1861550089
Name:GARRATT, DEBBIE M (FNP-C)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:M
Last Name:GARRATT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAILEY
Mailing Address - State:ID
Mailing Address - Zip Code:83333-8400
Mailing Address - Country:US
Mailing Address - Phone:208-788-3434
Mailing Address - Fax:208-788-2025
Practice Address - Street 1:706 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HAILEY
Practice Address - State:ID
Practice Address - Zip Code:83333-8400
Practice Address - Country:US
Practice Address - Phone:208-788-3434
Practice Address - Fax:208-788-2025
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP375A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807446200Medicaid
IDNP375AOtherLICENSE NUMBER
ID1345713Medicare PIN
ID807446200Medicaid