Provider Demographics
NPI:1588035604
Name:PISER, DEBORAH LEE (NP-C)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LEE
Last Name:PISER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30W MCCREIGHT AVE
Mailing Address - Street 2:209
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1842
Mailing Address - Country:US
Mailing Address - Phone:937-523-9940
Mailing Address - Fax:
Practice Address - Street 1:860 MAIN RD
Practice Address - Street 2:
Practice Address - City:CORFU
Practice Address - State:NY
Practice Address - Zip Code:14036-9753
Practice Address - Country:US
Practice Address - Phone:937-321-4846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA-17957-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0150541Medicaid
OH0150541Medicaid