Healthcare Provider Details

I. General information

NPI: 1639361892
Provider Name (Legal Business Name): DEBORAH R. CASSON N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 MERRIMAC ST
NEWBURYPORT MA
01950-2192
US

IV. Provider business mailing address

260 MERRIMAC ST
NEWBURYPORT MA
01950-2192
US

V. Phone/Fax

Practice location:
  • Phone: 978-499-7400
  • Fax: 978-499-7488
Mailing address:
  • Phone: 978-499-7400
  • Fax: 978-499-7488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number238294
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: