Provider Demographics
NPI:1578004263
Name:STUMP, DEBRA LEIGH (FNP-C)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LEIGH
Last Name:STUMP
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3590 BUSENBARK RD
Mailing Address - Street 2:STE. 400
Mailing Address - City:TRENTON
Mailing Address - State:OH
Mailing Address - Zip Code:45067-9552
Mailing Address - Country:US
Mailing Address - Phone:513-988-6369
Mailing Address - Fax:513-988-9369
Practice Address - Street 1:3590 BUSENBARK RD
Practice Address - Street 2:#400
Practice Address - City:TRENTON
Practice Address - State:OH
Practice Address - Zip Code:45067-9552
Practice Address - Country:US
Practice Address - Phone:513-988-6369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020527363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAPRNCNP020527OtherOHIO BOARD OF NURSING
OHF02170090OtherAMERICAN ASSOCIATION OF NURSE PRACTITIONERS