Healthcare Provider Details

I. General information

NPI: 1790298230
Provider Name (Legal Business Name): DEBORAH LYNN HOTCHKISS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH LYNN KAHLE

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 08/27/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 SPORTSMAN DR
CLARION PA
16214-8572
US

IV. Provider business mailing address

18 SPORTSMAN DR
CLARION PA
16214-8572
US

V. Phone/Fax

Practice location:
  • Phone: 814-226-6062
  • Fax:
Mailing address:
  • Phone: 814-226-6062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP018074
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: