Provider Demographics
NPI:1255401857
Name:CHAMBERLAIN, DEBORAH ANNE (PT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANNE
Last Name:CHAMBERLAIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 PIONEER CIR
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-6782
Mailing Address - Country:US
Mailing Address - Phone:603-759-1757
Mailing Address - Fax:
Practice Address - Street 1:281 SAWYER DR STE 200
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-3412
Practice Address - Country:US
Practice Address - Phone:970-259-2464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0013728225100000X
NH05642251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH626514OtherHARVARD PILGRIM
NH761242OtherTUFTS
NH08Y002970NH02OtherBCBS
NH272746OtherCIGNA
NH99560056Medicaid
NH561822OtherAETNA
NH020377315OtherCOMM TAX ID