Healthcare Provider Details

I. General information

NPI: 1902822661
Provider Name (Legal Business Name): DEBORAH B DUTTON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 09/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 HOSPITAL DR
SALEM KY
42078-8043
US

IV. Provider business mailing address

PO BOX 347
SALEM KY
42078-0347
US

V. Phone/Fax

Practice location:
  • Phone: 270-988-3298
  • Fax: 270-988-4642
Mailing address:
  • Phone: 270-988-3298
  • Fax: 270-988-4642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number3400P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: