Provider Demographics
NPI:1942661558
Name:CHARLES, DEBORAH S (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:CHARLES
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:S
Other - Last Name:PAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 GRIFFIN RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7158
Mailing Address - Country:US
Mailing Address - Phone:036-923-1666
Mailing Address - Fax:833-944-2258
Practice Address - Street 1:100 GRIFFIN RD UNIT B
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7158
Practice Address - Country:US
Practice Address - Phone:603-692-3166
Practice Address - Fax:833-944-2258
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME043501163W00000X
MECNP161099208VP0000X, 363LF0000X
NH078104-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine