National Provider Identifier
Debra Lou Mountain, LPN
Debra Lou Mountain, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Corning, NY and a listed phone number of (419) 239-7586.
Profile Overview
- NPI
- 1740902212
- Provider Type
- Individual
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- September 13, 2022
- Last Updated
- September 13, 2022
Practice Location
- 15 Sims Avenue
- Corning, NY 14830
Phone: (419) 239-7586
Specialties
- Licensed Practical Nurse (164W00000X)
Full Record
- NPI
- 1740902212
- Entity Type
- Individual
- Last Name
- Mountain
- First Name
- Debra
- Middle Name
- Lou
- Name Prefix
- Mrs.
- Credential
- LPN
- Provider Other Last Name
- Wilk
- Provider Other First Name
- Debra
- Provider Other Middle Name
- Lou
- Provider Other Name Prefix Text
- MS.
- Provider Other Credential Text
- LPN
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 15 Sims Avenue
- Mailing City
- Corning
- Mailing State
- NY
- Mailing ZIP Code
- 14830
- Mailing Country
- US
- Mailing Phone
- (419) 239-7586
- Practice Street Address
- 15 Sims Avenue
- Practice City
- Corning
- Practice State
- NY
- Practice ZIP Code
- 14830
- Practice Country
- US
- Practice Phone
- (419) 239-7586
- Enumeration Date
- September 13, 2022
- Last Updated
- September 13, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- September 13, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Licensed Practical Nurse (164W00000X)