Provider Demographics
NPI:1891801478
Name:ANDERSON, DEBORAH RUANE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:RUANE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:127 ONEIDA VALLEY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-2246
Mailing Address - Country:US
Mailing Address - Phone:833-604-7211
Mailing Address - Fax:
Practice Address - Street 1:11676 PERRY HWY ST
Practice Address - Street 2:SUITE 1308
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15044
Practice Address - Country:US
Practice Address - Phone:724-933-0155
Practice Address - Fax:724-933-0833
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPASP007241363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P24358Medicare UPIN
PA052397X2NMedicare PIN