Provider Demographics
NPI:1063296895
Name:BAUM, DEBORAH DA SILVA (PMHNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:DA SILVA
Last Name:BAUM
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:BAUM
Other - Last Name:MUNTIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4801 E MCDOWELL RD STE 250
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-7725
Mailing Address - Country:US
Mailing Address - Phone:602-464-9576
Mailing Address - Fax:480-428-0475
Practice Address - Street 1:16620 N 40TH ST STE E1
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-3357
Practice Address - Country:US
Practice Address - Phone:602-464-9576
Practice Address - Fax:480-428-0475
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ296639363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health