Provider Demographics
NPI:1598371775
Name:STINSON, DEBORAH
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:STINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 854
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:WV
Mailing Address - Zip Code:24811
Mailing Address - Country:US
Mailing Address - Phone:304-938-5079
Mailing Address - Fax:
Practice Address - Street 1:227 BETSY BRANCH RD
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:WV
Practice Address - Zip Code:24811
Practice Address - Country:US
Practice Address - Phone:304-938-5079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant