Provider Demographics
NPI:1295099133
Name:TETLOW, DEBORAH (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:TETLOW
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 GILLETT RD
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-9510
Mailing Address - Country:US
Mailing Address - Phone:585-352-6844
Mailing Address - Fax:
Practice Address - Street 1:691 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14605-1706
Practice Address - Country:US
Practice Address - Phone:585-753-5240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator