Provider Demographics
NPI:1043921307
Name:HALLINAN, DEBRA SUSAN (RN)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:SUSAN
Last Name:HALLINAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SUN SET RD
Mailing Address - Street 2:
Mailing Address - City:BOOTHBAY HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04538-2233
Mailing Address - Country:US
Mailing Address - Phone:207-380-9336
Mailing Address - Fax:
Practice Address - Street 1:12 SUN SET RD
Practice Address - Street 2:
Practice Address - City:BOOTHBAY HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04538-2233
Practice Address - Country:US
Practice Address - Phone:207-380-9336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN2503163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse