Provider Demographics
NPI:1952373854
Name:FRENCH, DEBORAH ANN (PA C)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:FRENCH
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 KENTUCKY AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-3803
Mailing Address - Country:US
Mailing Address - Phone:270-366-7650
Mailing Address - Fax:270-443-0660
Practice Address - Street 1:2605 KENTUCKY AVE STE 402
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3803
Practice Address - Country:US
Practice Address - Phone:270-366-7650
Practice Address - Fax:270-443-0660
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA779363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY95005633Medicaid
KYK005960Medicare PIN
KY0627504Medicare ID - Type Unspecified