Debra Lynn Fife, LPN

Individual provider Active NPI Licensed Practical Nurse · Charlestown, IN

NPI 1225833148 · NPPES record last updated Feb 14, 2025

Key facts

NPI
1225833148
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
27025026A (IN)
Practice address
Southern Indiana CTC
7509 Charlestown Pike
Charlestown, IN 47111
Phone
(812) 256-4686
NPI assigned
Feb 14, 2025
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
27025026AINMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 27025026A IN Yes

Addresses

Primary practice location

Southern Indiana CTC
7509 Charlestown Pike
Charlestown, IN 47111

Mailing address

Southern Indiana CTC
7509 Charlestown Pike
Charlestown, IN 47111
Phone (812) 256-4686

Other providers in Charlestown, IN

All providers in Charlestown, IN · Licensed Practical Nurse in Indiana

Sources for this page

Verify at the official NPI Registry.