1447331830 NPI number — MS. DEBORAH LYNN CHASE FNP-C

Table of content: EDUARDO MACIAS ENRIQUEZ MD (NPI 1982946455)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447331830 NPI number — MS. DEBORAH LYNN CHASE FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHASE
Provider First Name:
DEBORAH
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NITTMANN
Provider Other First Name:
DEBORAH
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447331830
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 40104
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELFAST
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04915-1239
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-547-5138
Provider Business Mailing Address Fax Number:
719-547-4374

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
704 FORTINO BLVD STE D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PUEBLO
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81008-2087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-547-5138
Provider Business Practice Location Address Fax Number:
719-547-4374
Provider Enumeration Date:
10/18/2006

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: 208D00000X , with the licence number:  3763NP , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 118112 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 3763 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 0003763 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 56884346 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 113453200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".