Provider Demographics
NPI:1174718209
Name:ROBERTS, DEBORAH (RN, ARM, LNC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:RN, ARM, LNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 57
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-0057
Mailing Address - Country:US
Mailing Address - Phone:907-260-9446
Mailing Address - Fax:
Practice Address - Street 1:4341 B ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5927
Practice Address - Country:US
Practice Address - Phone:907-770-0862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK13891163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse