Provider Demographics
NPI:1053602482
Name:NUNN, DEBORAH CAROL (RPH)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:CAROL
Last Name:NUNN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17380 CORKSCREW RD
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-9417
Mailing Address - Country:US
Mailing Address - Phone:239-910-7126
Mailing Address - Fax:
Practice Address - Street 1:9150 KINGS CROSSING RD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-0848
Practice Address - Country:US
Practice Address - Phone:239-284-1702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS30257183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist