Provider Demographics
NPI:1609537570
Name:BROWN, DEBORAH L (CRNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:L
Other - Last Name:MOFFETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:250 W LANCASTER AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1798
Mailing Address - Country:US
Mailing Address - Phone:610-644-8069
Mailing Address - Fax:610-644-6736
Practice Address - Street 1:250 W LANCASTER AVE STE 120
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1798
Practice Address - Country:US
Practice Address - Phone:610-644-8069
Practice Address - Fax:610-644-6736
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023744363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily