Provider Demographics
NPI:1053530212
Name:HARRISON, DEBRA (CPNP)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:TILGHMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPNP
Mailing Address - Street 1:3286 REDDEN FERRY RD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:MD
Mailing Address - Zip Code:21822-2229
Mailing Address - Country:US
Mailing Address - Phone:410-677-0666
Mailing Address - Fax:410-677-0667
Practice Address - Street 1:100 E CARROLL ST
Practice Address - Street 2:PEDIATRIC SPECIALTY SERVICES
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5422
Practice Address - Country:US
Practice Address - Phone:410-543-7729
Practice Address - Fax:410-543-7586
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR078461363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner