Provider Demographics
NPI:1417548520
Name:KOMORA, DEBORAH LYNNE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LYNNE
Last Name:KOMORA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 S MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-2707
Mailing Address - Country:US
Mailing Address - Phone:412-487-2883
Mailing Address - Fax:
Practice Address - Street 1:110 FORT COUCH RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1030
Practice Address - Country:US
Practice Address - Phone:412-831-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023128363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily