Provider Demographics
NPI:1831220722
Name:VANVELTHOVEN, DEBORAH (NNP,C)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:VANVELTHOVEN
Suffix:
Gender:F
Credentials:NNP,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 CONCORD TER
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2843
Mailing Address - Country:US
Mailing Address - Phone:954-384-0175
Mailing Address - Fax:877-780-4242
Practice Address - Street 1:300 2ND AVE
Practice Address - Street 2:CHILDRENS HOSPITAL AT MONMOUTH MEDICAL CENTER
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6303
Practice Address - Country:US
Practice Address - Phone:732-923-6860
Practice Address - Fax:732-923-7255
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN08639200363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal