Healthcare Provider Details

I. General information

NPI: 1215093877
Provider Name (Legal Business Name): DEBORAH LYNN LENKEIT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STUTTGART HEALTH CLINIC PATCH BARRACKS UNIT 30401
APO AE
09107
DE

IV. Provider business mailing address

ATTN CREDENTIALS OFFICE CMR 442
APO AE
09042
DE

V. Phone/Fax

Practice location:
  • Phone: 497116808610
  • Fax: 497116808619
Mailing address:
  • Phone: 496221172274
  • Fax: 496221172941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR150381
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: