Basic Information
| Provider Information | |||||||||
| NPI: | 1811069875 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASDORPH | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 609 | ||||||||
| Address2: | |||||||||
| City: | ELIZABETH | ||||||||
| State: | WV | ||||||||
| PostalCode: | 261430609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042753301 | ||||||||
| FaxNumber: | 3042754798 | ||||||||
| Practice Location | |||||||||
| Address1: | 512A SOUTH CHURCH STREET | ||||||||
| Address2: | |||||||||
| City: | RIPLEY | ||||||||
| State: | WV | ||||||||
| PostalCode: | 25271 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043721033 | ||||||||
| FaxNumber: | 3043730223 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2006 | ||||||||
| LastUpdateDate: | 08/10/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 20278 | WV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.