Provider Demographics
NPI:1407034002
Name:VIEIRA, DEBORAH J (MA)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:J
Last Name:VIEIRA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:SUREFIRE
Other - Middle Name:HEALTHCARE
Other - Last Name:PROFESSIONALS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:124 E CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:CREWE
Mailing Address - State:VA
Mailing Address - Zip Code:23930-1802
Mailing Address - Country:US
Mailing Address - Phone:540-848-0183
Mailing Address - Fax:434-538-0121
Practice Address - Street 1:124 E CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:CREWE
Practice Address - State:VA
Practice Address - Zip Code:23930-1802
Practice Address - Country:US
Practice Address - Phone:434-538-0120
Practice Address - Fax:454-538-0121
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401029093376K00000X
VAHCO-11671251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No251E00000XAgenciesHome Health