Healthcare Provider Details

I. General information

NPI: 1437161387
Provider Name (Legal Business Name): DEBORAH A. STAMPER MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5515 W 38TH ST
INDIANAPOLIS IN
46254-2919
US

IV. Provider business mailing address

13800 E BASE RD
COLUMBUS IN
47203-9652
US

V. Phone/Fax

Practice location:
  • Phone: 317-880-3838
  • Fax: 317-880-0081
Mailing address:
  • Phone: 812-579-6781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number70000094A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License Number70000094
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: