Provider Demographics
NPI:1205088879
Name:ASTEMBORSKI, DEBORAH MARIE (ACNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MARIE
Last Name:ASTEMBORSKI
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:MARIE
Other - Last Name:SHEPHERD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP
Mailing Address - Street 1:PO BOX 80217
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060-0217
Mailing Address - Country:US
Mailing Address - Phone:602-385-2115
Mailing Address - Fax:480-418-3323
Practice Address - Street 1:6760 W THUNDERBIRD RD STE E110
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-5027
Practice Address - Country:US
Practice Address - Phone:602-648-5445
Practice Address - Fax:602-772-3801
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3149363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ817539Medicaid
AZ817539Medicaid