Sharon Faye Deburen, NURSE PRACTITIONER

Individual provider Active NPI Obstetrics & Gynecology Nurse Practitioner · Tiburon, CA

NPI 1235219239 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1235219239
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Nurse Practitioner 363LX0001X
License
V163669 (CA)
Practice address
35 Via Los Altos
Tiburon, CA 94920-2059
Phone
(415) 383-1405
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

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
V163669CAMDObstetrics & Gynecology Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X V163669 CA Yes

Addresses

Primary practice location

35 Via Los Altos
Tiburon, CA 94920-2059

Mailing address

35 Via Los Altos
Tiburon, CA 94920-2059
Phone (415) 383-1405

Other providers in Tiburon, CA

All providers in Tiburon, CA · Obstetrics & Gynecology Nurse Practitioner in California

Sources for this page

Verify at the official NPI Registry.