Provider Demographics
NPI:1730302753
Name:HOWARD, DEBORAH D (RN, MS, PNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:D
Last Name:HOWARD
Suffix:
Gender:F
Credentials:RN, MS, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 E BASELINE RD STE 108
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4616
Mailing Address - Country:US
Mailing Address - Phone:480-892-3880
Mailing Address - Fax:480-545-4551
Practice Address - Street 1:4540 E BASELINE RD STE 108
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4616
Practice Address - Country:US
Practice Address - Phone:480-892-3880
Practice Address - Fax:480-545-4551
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN069054363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics