Provider Demographics
NPI:1629024823
Name:COLON, DEBORAH S (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:COLON
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:S
Other - Last Name:YEAGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 S BEHL ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:MN
Mailing Address - Zip Code:56208-1616
Mailing Address - Country:US
Mailing Address - Phone:320-289-1580
Mailing Address - Fax:
Practice Address - Street 1:30 S BEHL ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:MN
Practice Address - Zip Code:56208-1616
Practice Address - Country:US
Practice Address - Phone:320-289-1580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1751363LP0808X
MNR1459773363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q33653Medicare UPIN