Provider Demographics
NPI:1811606460
Name:HASTINGS, DEBORA RENEE
Entity type:Individual
Prefix:
First Name:DEBORA
Middle Name:RENEE
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 ROWLAND AVE NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44705-1569
Mailing Address - Country:US
Mailing Address - Phone:330-356-9211
Mailing Address - Fax:
Practice Address - Street 1:1450 ROWLAND AVE NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44705-1569
Practice Address - Country:US
Practice Address - Phone:330-356-9211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker