Provider Demographics
NPI:1174857783
Name:CODDE, DEBORAH GAYE
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:GAYE
Last Name:CODDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1590
Mailing Address - Country:US
Mailing Address - Phone:269-781-9994
Mailing Address - Fax:
Practice Address - Street 1:120 S HAMILTON ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1590
Practice Address - Country:US
Practice Address - Phone:269-781-9994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula