Provider Demographics
NPI:1881145126
Name:LAVERTY, DEBORAH KAY (MSN, NP-C)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:KAY
Last Name:LAVERTY
Suffix:
Gender:F
Credentials:MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41705 N CLUB POINTE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1961
Mailing Address - Country:US
Mailing Address - Phone:602-615-4422
Mailing Address - Fax:623-328-7386
Practice Address - Street 1:8914 N 91ST AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-8396
Practice Address - Country:US
Practice Address - Phone:623-877-0100
Practice Address - Fax:623-328-7386
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9573363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily