Healthcare Provider Details

I. General information

NPI: 1598800153
Provider Name (Legal Business Name): DEBORAH KAREN CAGLE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 W MAIN ST
MORRISTOWN TN
37814-4632
US

IV. Provider business mailing address

1036 SHIELDS RIDGE RD
NEW MARKET TN
37820-5016
US

V. Phone/Fax

Practice location:
  • Phone: 423-586-6431
  • Fax: 423-586-6324
Mailing address:
  • Phone: 865-397-0327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN0000120386
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: