Provider Demographics
NPI:1922498898
Name:ROONEY, DEBORAH J (APRN)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:ROONEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:J
Other - Last Name:MCCRADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:105 LOUDON RD BLDG 3
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 LOUDON RD BLDG 3
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5600
Practice Address - Country:US
Practice Address - Phone:603-821-7788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-30
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH046873-21163W00000X
NH046873-23163WP0808X
NH046879-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3105360Medicaid