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General NPI Number Information
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NPI Number | 1326255969
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Entity Type | Individual
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Provider Name | DEBORAH V. THOMAS EDD, APRN, BC
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 06/01/2022
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Provider Practice Location Address
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Address Line | 9509 US HIGHWAY 42 STE 108
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City | PROSPECT
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State | KY
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Zip | 40059-9291
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Country | US
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Telephone | 502-709-4717
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Fax | 502-709-4727
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Provider Business Mailing Address
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Address Line | 9509 US HIGHWAY 42 STE 108
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City | PROSPECT
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State | KY
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Zip | 40059-9291
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Country | US
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Telephone | 502-709-4717
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Fax | 502-709-4727
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3002453
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 364SP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 3002453
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License Number State | KY
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