Provider Demographics
NPI:1306139365
Name:UPCHURCH HOWARD, DEBORAH (APN)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:UPCHURCH HOWARD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:WARTBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37887-0368
Mailing Address - Country:US
Mailing Address - Phone:423-346-5566
Mailing Address - Fax:423-346-5631
Practice Address - Street 1:1236 KNOXVILLE HWY
Practice Address - Street 2:
Practice Address - City:WARTBURG
Practice Address - State:TN
Practice Address - Zip Code:37887-4200
Practice Address - Country:US
Practice Address - Phone:423-346-5566
Practice Address - Fax:423-346-5631
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000015730364SA2100X
NC5014398363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1527937Medicaid