Provider Demographics
NPI:1396770319
Name:BRANSON, DEBORAH (RN, NP)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:BRANSON
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8 CADILLAC DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5087
Mailing Address - Country:US
Mailing Address - Phone:615-425-4200
Mailing Address - Fax:615-425-4201
Practice Address - Street 1:3400 YOUNGFIELD ST
Practice Address - Street 2:(INSIDE KING SOOPERS)
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-5245
Practice Address - Country:US
Practice Address - Phone:303-459-5645
Practice Address - Fax:303-459-5646
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO75112163W00000X
COAPN0001674NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12475068Medicaid
CO807977Medicare UPIN
CO807977Medicare Oscar/Certification
CO12475068Medicaid