Provider Demographics
NPI:1154424042
Name:CHUCK, DEBORAH LYNN
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNN
Last Name:CHUCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42931 STATE ROUTE 518
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:OH
Mailing Address - Zip Code:44432-9620
Mailing Address - Country:US
Mailing Address - Phone:330-424-1169
Mailing Address - Fax:330-420-0062
Practice Address - Street 1:42931 STATE ROUTE 518
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432-9620
Practice Address - Country:US
Practice Address - Phone:330-424-1169
Practice Address - Fax:330-420-0062
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide