Provider Demographics
NPI:1891914404
Name:COLEHOWER, DEBORAH R (NP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:R
Last Name:COLEHOWER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 MUZZEY ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-5256
Mailing Address - Country:US
Mailing Address - Phone:781-862-4110
Mailing Address - Fax:781-863-2007
Practice Address - Street 1:19 MUZZEY ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-5256
Practice Address - Country:US
Practice Address - Phone:781-862-4110
Practice Address - Fax:781-863-2007
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA268658363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics