Provider Demographics
NPI:1164527123
Name:CERRA, DEBORAH A (RN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:CERRA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1007
Mailing Address - Country:US
Mailing Address - Phone:570-346-7900
Mailing Address - Fax:570-964-5060
Practice Address - Street 1:940 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1007
Practice Address - Country:US
Practice Address - Phone:570-346-7900
Practice Address - Fax:570-964-5060
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN290459L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse