Provider Demographics
NPI:1083730543
Name:CARTIA, DEBORAH L (APRN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:CARTIA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:L
Other - Last Name:CARTIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:1221 S BROADWAY
Mailing Address - Street 2:LCSB-4
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2701
Mailing Address - Country:US
Mailing Address - Phone:859-258-4401
Mailing Address - Fax:859-258-4418
Practice Address - Street 1:1221 S BROADWAY
Practice Address - Street 2:LCSB-4
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2701
Practice Address - Country:US
Practice Address - Phone:859-258-4401
Practice Address - Fax:859-258-4418
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005758363L00000X
FLARNP9171222363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100200580Medicaid
KY7100200580Medicaid