Provider Demographics
NPI:1396863510
Name:BIRD, DEBORAH J (NP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:J
Last Name:BIRD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:180 E ANTELOPE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAKE
Mailing Address - State:CA
Mailing Address - Zip Code:93286-1506
Mailing Address - Country:US
Mailing Address - Phone:559-564-3538
Mailing Address - Fax:559-564-8411
Practice Address - Street 1:180 E ANTELOPE AVE
Practice Address - Street 2:
Practice Address - City:WOODLAKE
Practice Address - State:CA
Practice Address - Zip Code:93286-1506
Practice Address - Country:US
Practice Address - Phone:559-564-3538
Practice Address - Fax:559-564-8411
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP 9180363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily