Basic Information
| Provider Information | |||||||||
| NPI: | 1538245147 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEEPER | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 39 | ||||||||
| Address2: | |||||||||
| City: | MOREHEAD CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285570039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002280249 | ||||||||
| FaxNumber: | 2522223602 | ||||||||
| Practice Location | |||||||||
| Address1: | 907 RIVERGATE PKWY | ||||||||
| Address2: | SUITE C2020 | ||||||||
| City: | GOODLETTSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370722324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002280249 | ||||||||
| FaxNumber: | 2522223602 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | RN32198 | TN | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 3002445 | 01 | TN | TNCARE-BC SELECT | OTHER | 3002445 | 01 | TN | BLUE CROSS | OTHER |