Provider Demographics
NPI:1255504262
Name:SPOERNER, DEBORAH A (MSN, RN, CPNP)
Entity Type:Individual
Prefix:PROF
First Name:DEBORAH
Middle Name:A
Last Name:SPOERNER
Suffix:
Gender:F
Credentials:MSN, RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6208 HIGHLAND LN
Mailing Address - Street 2:
Mailing Address - City:MC CORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-9529
Mailing Address - Country:US
Mailing Address - Phone:317-335-1151
Mailing Address - Fax:
Practice Address - Street 1:509 NORTH ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47901-1152
Practice Address - Country:US
Practice Address - Phone:765-742-8589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002194A363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics