Individual provider Active NPI

Debora Nyachae

  • Registered Nurse
  • Grand Forks, ND
National Provider Identifier
1093625220
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1123919 Issued in TX
Practice address
402 Demers Ave Ste 200
Grand Forks, ND 58201-4573
Phone
(469) 856-0212
NPI assigned
Sep 10, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 1123919 TX Primary

Addresses

Primary practice location

402 Demers Ave Ste 200
Grand Forks, ND 58201-4573

Mailing address

4314 Quail Field Dr
Arlington, TX 76001-7636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1788998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1093625220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 QUAIL FIELD DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760017636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 DEMERS AVE STE 200",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014573",
            "telephone_number": "469-856-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYACHAE",
        "first_name": "DEBORA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1123919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.