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General NPI Number Information
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NPI Number | 1104008622
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Entity Type | Organization
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Legal Business Name | DEBORAH A STAMP
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 10/22/2009
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Provider Practice Location Address
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Address Line | 4112 SW 50TH AVE
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City | AMARILLO
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State | TX
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Zip | 79109-6128
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Country | US
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Telephone | 806-352-9992
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Fax | 806-352-9998
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Provider Business Mailing Address
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Address Line | 4112 SW 50TH AVE
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City | AMARILLO
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State | TX
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Zip | 79109-6128
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Country | US
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Telephone | 806-352-9992
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Fax | 806-352-9998
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Authorized Official
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Title or Position | OWNER/ADMIN
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Name | DEBORAH ANN STAMP
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Credential | RN, BSN
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Telephone | 806-352-9992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 009250
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License Number State | TX
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