Provider Demographics
NPI:1033364567
Name:HAHN, DEBORAH LEE (BSN,RN)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LEE
Last Name:HAHN
Suffix:
Gender:F
Credentials:BSN,RN
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:LEE
Other - Last Name:SHARP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN RN
Mailing Address - Street 1:61619 DOGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46544-9744
Mailing Address - Country:US
Mailing Address - Phone:574-633-4839
Mailing Address - Fax:
Practice Address - Street 1:61619 DOGWOOD RD.
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544
Practice Address - Country:US
Practice Address - Phone:574-633-4839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28167700A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse