Provider Demographics
NPI:1922131275
Name:MUELLER, DEBORAH WHITNEY (MSN APRN BC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:WHITNEY
Last Name:MUELLER
Suffix:
Gender:F
Credentials:MSN APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1458 BLUEBELL DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-1106
Mailing Address - Country:US
Mailing Address - Phone:518-392-3302
Mailing Address - Fax:
Practice Address - Street 1:COUNTY ROUTE 203 HOUSE#4279
Practice Address - Street 2:BOX 707
Practice Address - City:NORTH CHATHAM
Practice Address - State:NY
Practice Address - Zip Code:12132
Practice Address - Country:US
Practice Address - Phone:518-392-3302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250498-1364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS20054Medicare ID - Type Unspecified