Provider Demographics
NPI:1629208954
Name:WHITEHOUSE, DEBORAH CLARE (PSYCHIATRIC ARNP)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:CLARE
Last Name:WHITEHOUSE
Suffix:
Gender:F
Credentials:PSYCHIATRIC ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 LANCASTER AVE
Mailing Address - Street 2:204 ROWLETT BUILDING
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-3100
Mailing Address - Country:US
Mailing Address - Phone:859-622-1523
Mailing Address - Fax:
Practice Address - Street 1:239 W MAIN ST
Practice Address - Street 2:CITY HALL GROUND FLOOR
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-1592
Practice Address - Country:US
Practice Address - Phone:859-623-1633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1031777163WP0809X
KY379P363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult