Provider Demographics
NPI:1861995524
Name:NETZEL, DEBBIE JO (CNM)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:JO
Last Name:NETZEL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:JO
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2444
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-2444
Mailing Address - Country:US
Mailing Address - Phone:406-205-3111
Mailing Address - Fax:406-224-6401
Practice Address - Street 1:729 NUCLEUS AVE STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-4056
Practice Address - Country:US
Practice Address - Phone:406-205-3111
Practice Address - Fax:406-224-6401
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60835084367A00000X
MT132038367A00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife