Provider Demographics
NPI:1154712859
Name:VADURRO, DEBORAH (NP)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:VADURRO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 S 10TH ST STE 585
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5207
Mailing Address - Country:US
Mailing Address - Phone:215-955-5663
Mailing Address - Fax:215-955-6678
Practice Address - Street 1:132 S 10TH ST STE 585
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19107-5207
Practice Address - Country:US
Practice Address - Phone:215-955-5663
Practice Address - Fax:215-955-6678
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012689363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care