Provider Demographics
NPI:1457958084
Name:PREMPEH, DEBORAH A
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:PREMPEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 E DUBLIN GRANVILLE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3312
Mailing Address - Country:US
Mailing Address - Phone:614-805-1778
Mailing Address - Fax:614-392-0954
Practice Address - Street 1:1425 E DUBLIN GRANVILLE RD STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3312
Practice Address - Country:US
Practice Address - Phone:614-805-1778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2021-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH852384305Medicaid