1922131275 NPI number — DEBORAH WHITNEY MUELLER MSN APRN BC

Table of content: DEBORAH WHITNEY MUELLER MSN APRN BC (NPI 1922131275)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922131275 NPI number — DEBORAH WHITNEY MUELLER MSN APRN BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MUELLER
Provider First Name:
DEBORAH
Provider Middle Name:
WHITNEY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSN APRN BC
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:
1922131275
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1458 BLUEBELL DR NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALBUQUERQUE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87122-1106
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-392-3302
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
COUNTY ROUTE 203 HOUSE#4279
Provider Second Line Business Practice Location Address:
BOX 707
Provider Business Practice Location Address City Name:
NORTH CHATHAM
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-392-3302
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/14/2007

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: 364SP0809X , with the licence number:  250498-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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