Provider Demographics
NPI:1932181146
Name:PARTEN, DEBORAH SIMS (CRNA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SIMS
Last Name:PARTEN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 RAINBOW PKWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TOOMSUBA
Mailing Address - State:MS
Mailing Address - Zip Code:39364-1401
Mailing Address - Country:US
Mailing Address - Phone:601-693-7208
Mailing Address - Fax:
Practice Address - Street 1:2124 14TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-4040
Practice Address - Country:US
Practice Address - Phone:601-553-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR123790367500000X
FLARNP9297796367500000X
TN19601367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001619900Medicaid
MS00117964Medicaid
430030267OtherRAILROAD MEDICARE
430030267OtherRAILROAD MEDICARE
MS00117964Medicaid
430000745Medicare ID - Type Unspecified