Provider Demographics
NPI:1477946242
Name:MENTZER, DEBORAH A (CRNP, PMH)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:A
Last Name:MENTZER
Suffix:
Gender:F
Credentials:CRNP, PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-709-6529
Practice Address - Street 1:750 EDEN RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4712
Practice Address - Country:US
Practice Address - Phone:717-399-7381
Practice Address - Fax:717-391-7517
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014277363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN233545LOtherSTATE LICENSE - RN
PA103076720Medicaid
13608593OtherCAQH
PASP014277OtherSTATE LICENSE CRNP
PASP014277OtherSTATE LICENSE CRNP