Provider Demographics
NPI:1821787219
Name:KINGSLEY, DEBORAH LEE (RN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LEE
Last Name:KINGSLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1433
Mailing Address - Country:US
Mailing Address - Phone:973-747-7619
Mailing Address - Fax:877-371-1886
Practice Address - Street 1:26 CEDAR RD
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1433
Practice Address - Country:US
Practice Address - Phone:973-747-7619
Practice Address - Fax:877-371-1886
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO08030100163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Single Specialty