Provider Demographics
NPI:1720272602
Name:HEDLEY, DEBORAH DUBIN (NP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:DUBIN
Last Name:HEDLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9020 STONY POINT PKWY STE 240
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1980
Mailing Address - Country:US
Mailing Address - Phone:804-282-5236
Mailing Address - Fax:804-282-5547
Practice Address - Street 1:9020 STONY POINT PKWY STE 240
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1980
Practice Address - Country:US
Practice Address - Phone:804-282-5236
Practice Address - Fax:804-282-5547
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167253363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA016275R79Medicare PIN