Provider Demographics
NPI:1396153607
Name:COLGAN, DEBORAH (CNA)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:COLGAN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1952 COUNTY ROAD 170
Mailing Address - Street 2:
Mailing Address - City:MARENGO
Mailing Address - State:OH
Mailing Address - Zip Code:43334-9662
Mailing Address - Country:US
Mailing Address - Phone:740-816-5119
Mailing Address - Fax:
Practice Address - Street 1:1952 COUNTY ROAD 170
Practice Address - Street 2:
Practice Address - City:MARENGO
Practice Address - State:OH
Practice Address - Zip Code:43334-9662
Practice Address - Country:US
Practice Address - Phone:740-816-5119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide