Provider Demographics
NPI:1679810998
Name:THIEME, DEBORAH (CNA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:THIEME
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:TOLLEFSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:6502 E GOLF LINKS RD
Mailing Address - Street 2:APT. 154
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-4913
Mailing Address - Country:US
Mailing Address - Phone:520-304-9744
Mailing Address - Fax:
Practice Address - Street 1:5151 E BROADWAY BLVD
Practice Address - Street 2:STE. 1250
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-3705
Practice Address - Country:US
Practice Address - Phone:520-747-4100
Practice Address - Fax:520-514-4093
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCNA1741631033747A0650X, 3747P1801X, 374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide