Provider Demographics
NPI:1295734002
Name:HALL, DEBORAH YOUNG (RNC,WHCNP)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:YOUNG
Last Name:HALL
Suffix:
Gender:F
Credentials:RNC,WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 WONDER WORLD DR
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7546
Mailing Address - Country:US
Mailing Address - Phone:512-396-7575
Mailing Address - Fax:512-396-7555
Practice Address - Street 1:1305 WONDER WORLD DR
Practice Address - Street 2:SUITE 209
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7546
Practice Address - Country:US
Practice Address - Phone:512-396-7575
Practice Address - Fax:512-396-7555
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX674498363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX674498OtherBOARD OF NURSE EXAMINERS-