Provider Demographics
NPI:1073780102
Name:MAY, DEBORAH LYNN (CNS DNS)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNN
Last Name:MAY
Suffix:
Gender:F
Credentials:CNS DNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10748 WESTON DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-9319
Mailing Address - Country:US
Mailing Address - Phone:317-432-3077
Mailing Address - Fax:
Practice Address - Street 1:10748 WESTON DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-9319
Practice Address - Country:US
Practice Address - Phone:317-432-3077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN70000073A364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200931480Medicaid
INP01191771OtherRR MEDICARE PTAN
IN266180076Medicare PIN
IN150074Medicare PIN
IN165490IIIMedicare PIN
IN200931480Medicaid