Provider Demographics
NPI:1578167508
Name:ONTIVEROS, DEBORAH ANN (LVN/LPN)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH ANN
Middle Name:
Last Name:ONTIVEROS
Suffix:
Gender:F
Credentials:LVN/LPN
Other - Prefix:MS
Other - First Name:DEBORAH ANN
Other - Middle Name:
Other - Last Name:HUTCHINGS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LVN/LPN
Mailing Address - Street 1:1219 ELLSWORTH FARM
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-1534
Mailing Address - Country:US
Mailing Address - Phone:210-393-2659
Mailing Address - Fax:
Practice Address - Street 1:1219 ELLSWORTH FARM
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-1534
Practice Address - Country:US
Practice Address - Phone:210-393-2659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020125164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse