Provider Demographics
NPI:1700442266
Name:PRICE, DEBORAH KAYE (CNM, DRPH)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:KAYE
Last Name:PRICE
Suffix:
Gender:F
Credentials:CNM, DRPH
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:KAYE
Other - Last Name:CUNNINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM, DRPH
Mailing Address - Street 1:12251 JAMES ST STE 500
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-8944
Mailing Address - Country:US
Mailing Address - Phone:616-393-5732
Mailing Address - Fax:616-393-5767
Practice Address - Street 1:12251 JAMES ST STE 500
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-8944
Practice Address - Country:US
Practice Address - Phone:616-393-5732
Practice Address - Fax:616-393-5767
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704145702367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife