1447208186 NPI number — MRS. DEBORAH A DEGUIRE APRN, C-FNP

Table of content: MRS. DEBORAH A DEGUIRE APRN, C-FNP (NPI 1447208186)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447208186 NPI number — MRS. DEBORAH A DEGUIRE APRN, C-FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEGUIRE
Provider First Name:
DEBORAH
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN, C-FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447208186
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
141 HOSPITAL DR
Provider Second Line Business Mailing Address:
PO BOX 347
Provider Business Mailing Address City Name:
SALEM
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42078-0347
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-988-3298
Provider Business Mailing Address Fax Number:
270-988-4642

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 E ADAIR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SMITHLAND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42081-9164
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-928-2146
Provider Business Practice Location Address Fax Number:
270-928-4642
Provider Enumeration Date:
05/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  3001903 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 78000916 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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