Provider Demographics
NPI:1164722278
Name:MANSON, DEBORAH CRAVER (RN, BSN, HNC, CHTP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:CRAVER
Last Name:MANSON
Suffix:
Gender:F
Credentials:RN, BSN, HNC, CHTP
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:ANNE
Other - Last Name:CRAVER WOLFE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN BSN HNC CHTP
Mailing Address - Street 1:PO BOX 600
Mailing Address - Street 2:
Mailing Address - City:TUBA CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86045-0600
Mailing Address - Country:US
Mailing Address - Phone:928-283-2520
Mailing Address - Fax:928-283-2677
Practice Address - Street 1:167 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:TUBA CITY
Practice Address - State:AZ
Practice Address - Zip Code:86045-0600
Practice Address - Country:US
Practice Address - Phone:928-283-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN136157163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse