Provider Demographics
NPI:1588025407
Name:MEAR, DEBORAH KIM (RN)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:KIM
Last Name:MEAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 DALE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2058
Mailing Address - Country:US
Mailing Address - Phone:585-381-5631
Mailing Address - Fax:585-387-9005
Practice Address - Street 1:169 DALE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2058
Practice Address - Country:US
Practice Address - Phone:585-381-5631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-20
Last Update Date:2016-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY635404163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse