Provider Demographics
NPI:1699009522
Name:BREWSTER-YATOR, DEBORAH KAY (CRNA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:KAY
Last Name:BREWSTER-YATOR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:151 PENNSYLVANIA PKWY
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46280-1379
Practice Address - Country:US
Practice Address - Phone:317-732-0050
Practice Address - Fax:317-732-0050
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23841367500000X
VA0001186449367500000X
IN28204878A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD419235400Medicaid
IN264430F56OtherMEDICARE PTAN
IN095200089OtherMEDICARE PTAN