Provider Demographics
NPI:1578114401
Name:DENNY, DEBORAH
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:DENNY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:RENEE
Other - Last Name:DENNY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX A
Mailing Address - Street 2:
Mailing Address - City:CROWDER
Mailing Address - State:OK
Mailing Address - Zip Code:74430
Mailing Address - Country:US
Mailing Address - Phone:918-470-9552
Mailing Address - Fax:
Practice Address - Street 1:162 FRIENDSHIP ROAD
Practice Address - Street 2:
Practice Address - City:CROWDER
Practice Address - State:OK
Practice Address - Zip Code:74430
Practice Address - Country:US
Practice Address - Phone:918-470-9552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider