Provider Demographics
NPI:1659302529
Name:SPINNER, DEBORAH L (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:L
Last Name:SPINNER
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:11850 W MARKET PL
Mailing Address - Street 2:SUITE P
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2670
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:240-485-5407
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:DEPT OF LABOR & DELIVERY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:443-849-2577
Practice Address - Fax:410-296-9009
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR093895363LX0001X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD465392YYKMedicare PIN
MD994LMedicare UPIN
MD719LO824Medicare PIN
MDKJ43/896861-01OtherCAREFIRST MARYLAND
MD410598200Medicaid