Provider Demographics
NPI:1740580968
Name:ROMERO, DEBORAH CARSLEY (FNP BC, CDE)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:CARSLEY
Last Name:ROMERO
Suffix:
Gender:F
Credentials:FNP BC, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1288
Mailing Address - Street 2:1200 AIRPORT ROAD
Mailing Address - City:HOOPA
Mailing Address - State:CA
Mailing Address - Zip Code:95546-1288
Mailing Address - Country:US
Mailing Address - Phone:530-625-4261
Mailing Address - Fax:530-625-4519
Practice Address - Street 1:1200 AIRPORT ROAD
Practice Address - Street 2:
Practice Address - City:HOOPA
Practice Address - State:CA
Practice Address - Zip Code:95546-1288
Practice Address - Country:US
Practice Address - Phone:530-625-4261
Practice Address - Fax:530-625-4519
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA346020163WD0400X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator