Basic Information
Provider Information
NPI: 1568601268
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARTENFELD
FirstName: DEBRA
MiddleName: H
NamePrefix: MS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1670 CLAIRMONT RD # CSC151
Address2: ATLANTA VAMC
City: DECATUR
State: GA
PostalCode: 300334004
CountryCode: US
TelephoneNumber: 4043216111
FaxNumber: 4043274005
Practice Location
Address1: 1670 CLAIRMONT RD # CSC151
Address2: ATLANTA VAMC
City: DECATUR
State: GA
PostalCode: 300334004
CountryCode: US
TelephoneNumber: 4043216111
FaxNumber: 4043274005
Other Information
ProviderEnumerationDate: 02/19/2009
LastUpdateDate: 02/19/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN082659GAY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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