Healthcare Provider Details

I. General information

NPI: 1154724201
Provider Name (Legal Business Name): DEBORAH A PUNSHON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2014
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6651 FRANK AVE NW
NORTH CANTON OH
44720-8442
US

IV. Provider business mailing address

6651 FRANK AVE NW
NORTH CANTON OH
44720-8442
US

V. Phone/Fax

Practice location:
  • Phone: 330-498-9865
  • Fax: 330-498-9869
Mailing address:
  • Phone: 330-498-9865
  • Fax: 440-277-8196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number50.003829RX
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.003829
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: