Provider Demographics
NPI:1275760605
Name:LOMBARD, DEBORAH LYNN (ARNP, CNM)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNN
Last Name:LOMBARD
Suffix:
Gender:F
Credentials:ARNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 CRESSA CIR
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32926-2462
Mailing Address - Country:US
Mailing Address - Phone:321-609-4489
Mailing Address - Fax:
Practice Address - Street 1:362 CRESSA CIR
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32926-2462
Practice Address - Country:US
Practice Address - Phone:321-609-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1185302363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner