Provider Demographics
NPI:1295700748
Name:FAUTSCH, DEBORAH S (CNM)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:FAUTSCH
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 DELHI ST
Mailing Address - Street 2:STE 3100
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6358
Mailing Address - Country:US
Mailing Address - Phone:563-557-5959
Mailing Address - Fax:563-557-5950
Practice Address - Street 1:1500 DELHI ST
Practice Address - Street 2:STE 3100
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6358
Practice Address - Country:US
Practice Address - Phone:563-557-5959
Practice Address - Fax:563-557-5950
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB-093407367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife