Provider Demographics
NPI:1760404016
Name:REED, DEBORAH LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNN
Last Name:REED
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:LYNN
Other - Last Name:BALLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5224 E I 240 SERVICE RD FL 2
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-2607
Mailing Address - Country:US
Mailing Address - Phone:405-608-3800
Mailing Address - Fax:405-628-6793
Practice Address - Street 1:5224 E I 240 SERVICE RD FL 2
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73135-2607
Practice Address - Country:US
Practice Address - Phone:405-608-3800
Practice Address - Fax:405-628-6793
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
OK1546363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q71597Medicare UPIN