Provider Demographics
NPI:1386981322
Name:PUTMAN, DEBORAH LEANN (CRNP)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LEANN
Last Name:PUTMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:LEANN
Other - Last Name:CONDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3515 CLOVERDALE RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35633-1301
Mailing Address - Country:US
Mailing Address - Phone:256-284-7706
Mailing Address - Fax:256-284-7711
Practice Address - Street 1:3515 CLOVERDALE RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35633-1301
Practice Address - Country:US
Practice Address - Phone:256-284-7706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-064057363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL299733Medicaid