Provider Demographics
NPI:1912135617
Name:KAUFFMAN, DEBORAH ELLEN
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ELLEN
Last Name:KAUFFMAN
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 1:108 CHADBOURNE HILL RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04009-4508
Mailing Address - Country:US
Mailing Address - Phone:207-647-5909
Mailing Address - Fax:
Practice Address - Street 1:108 CHADBOURNE HILL RD
Practice Address - Street 2:
Practice Address - City:BRIDGTON
Practice Address - State:ME
Practice Address - Zip Code:04009-4508
Practice Address - Country:US
Practice Address - Phone:207-647-5909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME608175402Medicaid