Provider Demographics
NPI:1114124393
Name:STATLER, DEBORAH D (RN, APN)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:D
Last Name:STATLER
Suffix:
Gender:F
Credentials:RN, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 BLUE BEACH RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-4823
Mailing Address - Country:US
Mailing Address - Phone:302-678-2662
Mailing Address - Fax:302-678-2662
Practice Address - Street 1:CHILD DEVELOPMENT WATCH
Practice Address - Street 2:18 N. WALNUT ST.
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963
Practice Address - Country:US
Practice Address - Phone:302-424-7300
Practice Address - Fax:302-422-1363
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0022988163W00000X
DEL1-0000112364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist