Provider Demographics
NPI:1487738670
Name:ONAN, DEBORAH
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:ONAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:ANN
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP DNP
Mailing Address - Street 1:3675 SMITH STAPLES RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-9388
Mailing Address - Country:US
Mailing Address - Phone:615-542-8053
Mailing Address - Fax:615-246-4197
Practice Address - Street 1:3675 SMITH STAPLES RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-9388
Practice Address - Country:US
Practice Address - Phone:615-542-8053
Practice Address - Fax:615-246-4197
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006650363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P73714Medicare UPIN