Provider Demographics
NPI:1710418140
Name:THORPE, DEBORAH MAE (RN, CNS)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MAE
Last Name:THORPE
Suffix:
Gender:F
Credentials:RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 CLEARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-6716
Mailing Address - Country:US
Mailing Address - Phone:831-235-2101
Mailing Address - Fax:
Practice Address - Street 1:1080 CLEARVIEW DR
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-6716
Practice Address - Country:US
Practice Address - Phone:831-235-2101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3760364SN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SN0000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistNeonatal