Provider Demographics
NPI:1154724201
Name:PUNSHON, DEBORAH A (PA-C)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:PUNSHON
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6651 FRANK AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-8442
Mailing Address - Country:US
Mailing Address - Phone:330-498-9865
Mailing Address - Fax:330-498-9869
Practice Address - Street 1:6651 FRANK AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-8442
Practice Address - Country:US
Practice Address - Phone:330-498-9865
Practice Address - Fax:330-498-9869
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-03
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003829RX2084A0401X
OH50.003829363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine