Provider Demographics
NPI:1578559977
Name:GOBEL, DEBORAH T (CRNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:T
Last Name:GOBEL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:T
Other - Last Name:MANGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1600 SIXTH AVENUE
Mailing Address - Street 2:SUITE 117
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403
Mailing Address - Country:US
Mailing Address - Phone:717-840-9885
Mailing Address - Fax:717-840-9313
Practice Address - Street 1:1600 SIXTH AVENUE
Practice Address - Street 2:SUITE 117
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403
Practice Address - Country:US
Practice Address - Phone:717-840-9885
Practice Address - Fax:717-840-9313
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP000237F363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS62644Medicare UPIN
PA016413Medicare ID - Type Unspecified