Provider Demographics
NPI:1679514871
Name:KHALID-ABASI, DEBRA D (APN)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:D
Last Name:KHALID-ABASI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14601 AVALON AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-1304
Mailing Address - Country:US
Mailing Address - Phone:225-273-3426
Mailing Address - Fax:985-878-1431
Practice Address - Street 1:52579 HIGHWAY SOUTH
Practice Address - Street 2:LALLIE KEMP HOSPITAL
Practice Address - City:INDEPENDENCE
Practice Address - State:LA
Practice Address - Zip Code:70443
Practice Address - Country:US
Practice Address - Phone:985-878-9421
Practice Address - Fax:985-878-1431
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1168363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner