Provider Demographics
NPI:1750683496
Name:PEAY, DEBORAH LEIGH
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LEIGH
Last Name:PEAY
Suffix:
Gender:F
Credentials:
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 849
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664
Mailing Address - Country:US
Mailing Address - Phone:907-224-6960
Mailing Address - Fax:907-224-6919
Practice Address - Street 1:1907 SEWARD HWY
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664
Practice Address - Country:US
Practice Address - Phone:907-224-6960
Practice Address - Fax:907-224-6919
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist