Mary J Debbout, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

68464-30 Issued in WI

Practice address

744 S Webster Ave
Green Bay, WI 54305-3400

Phone

(920) 433-5582

NPI assigned

Feb 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1619004025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23400",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543053400",
            "telephone_number": "920-433-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543053400",
            "telephone_number": "920-433-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBBOUT",
        "first_name": "MARY",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "68464-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43309200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria D De Villa, M.D.
• Victor Adalbert Geraldez De Villa, M.D.
• Kathi Ellison Debaker, PTA
• Samantha Debauche
• Bobbi J Debbout, NP
• Gerald A Deboer, CRNA
• Abbey E Debruin, MD
• Anna Catherine Debruin, PT
• Deborah Lynn Decker, APNP
• Destiny Decker, DC

• Certified Registered Nurse Anesthetist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.