Provider Demographics
NPI:1164978540
Name:THORNE, DEBORAH L (PA)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:L
Last Name:THORNE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:111 W LUCERO AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-1829
Mailing Address - Country:US
Mailing Address - Phone:575-222-1834
Mailing Address - Fax:575-222-9705
Practice Address - Street 1:111 W LUCERO AVE STE 6
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-1829
Practice Address - Country:US
Practice Address - Phone:575-222-1834
Practice Address - Fax:575-222-9705
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2020-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY019935-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical