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NPI Code Detail

MEDICARE: MS. DEBORAH ANNE BODY DNP, FNP-C

MEDICARE: MS. DEBORAH ANNE BODY DNP, FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse438972NY
2363LF0000XFamily Nurse Practitioner331877NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194718387
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBORAH ANNE BODY DNP, FNP-C
Provider Business Mailing Address
First Line : 2445 STATE ROUTE 30
Second Line :
City : TUPPER LAKE
State : NY
Zip : 12986-2502
Country : US
Telephone Number : 518-554-8087
Fax Number : 518-359-4133
Provider Business Practice Location Address
First Line : 2445 STATE ROUTE 30
Second Line :
City : TUPPER LAKE
State : NY
Zip : 12986-2502
Country : US
Telephone Number : 518-554-8087
Fax Number : 518-359-4133
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2005
Last Update Date : 03/04/2020

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