Provider Demographics
NPI:1528313954
Name:BYRD, DEBORAH (LPN)
Entity type:Individual
Prefix:MISS
First Name:DEBORAH
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5417 ABBY LOOP WAY
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-3820
Mailing Address - Country:US
Mailing Address - Phone:937-469-7982
Mailing Address - Fax:
Practice Address - Street 1:5417 ABBY LOOP WAY
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-3820
Practice Address - Country:US
Practice Address - Phone:937-469-7982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.128331-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse