Healthcare Provider Details

I. General information

NPI: 1225276363
Provider Name (Legal Business Name): DEBORAH LEPORE MOYERS CRNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH ANNE LEPORE

II. Dates (important events)

Enumeration Date: 01/28/2009
Last Update Date: 06/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 WEST CYPRESS ST
KENNETT SQUARE PA
19348
US

IV. Provider business mailing address

731 WEST CYPRESS ST
KENNETT SQUARE PA
19348
US

V. Phone/Fax

Practice location:
  • Phone: 610-444-7550
  • Fax: 610-444-4656
Mailing address:
  • Phone: 610-444-7550
  • Fax: 610-444-4656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License NumberRN503670L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP010156
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: