Provider Demographics
NPI:1750482014
Name:LENTNER, DEBORAH P (PA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:P
Last Name:LENTNER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:H
Other - Last Name:PRESS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 1369
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-1369
Mailing Address - Country:US
Mailing Address - Phone:304-487-3407
Mailing Address - Fax:
Practice Address - Street 1:122 12TH ST STE A
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2312
Practice Address - Country:US
Practice Address - Phone:304-487-3407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV748363AM0700X
PAOX01107363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA310443WDYMedicare PIN