Provider Demographics
NPI:1497960686
Name:HARTER, DEBORAH F (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:F
Last Name:HARTER
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 1:3830 COUNTY ROAD 2
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14469-9708
Mailing Address - Country:US
Mailing Address - Phone:585-657-6513
Mailing Address - Fax:
Practice Address - Street 1:3045 COUNTY COMPLEX DR
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-9505
Practice Address - Country:US
Practice Address - Phone:585-393-3067
Practice Address - Fax:585-393-3060
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330952-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMH0134940OtherDEA LICENSE