Provider Demographics
NPI:1437161387
Name:STAMPER, DEBORAH A (MSN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:STAMPER
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13800 E BASE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-9652
Mailing Address - Country:US
Mailing Address - Phone:812-579-6781
Mailing Address - Fax:
Practice Address - Street 1:5515 W 38TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-2919
Practice Address - Country:US
Practice Address - Phone:317-880-3838
Practice Address - Fax:317-880-0081
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN70000094364SP0807X
IN70000094A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent