Provider Demographics
NPI:1487667606
Name:PEASE, DEBORAH D (FNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:D
Last Name:PEASE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 COOK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-3486
Mailing Address - Country:US
Mailing Address - Phone:423-744-7585
Mailing Address - Fax:423-744-7075
Practice Address - Street 1:711 COOK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-3486
Practice Address - Country:US
Practice Address - Phone:423-744-7585
Practice Address - Fax:423-744-7075
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000081347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3901773Medicaid
TN3901773Medicaid
TNS74975Medicare UPIN