Provider Demographics
NPI:1164978540
Name:THORNE, DEBORAH L (PA)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:L
Last Name:THORNE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2455 MISSOURI AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-5122
Mailing Address - Country:US
Mailing Address - Phone:575-222-1834
Mailing Address - Fax:575-222-2288
Practice Address - Street 1:2455 MISSOURI AVE STE B
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-5122
Practice Address - Country:US
Practice Address - Phone:575-222-1834
Practice Address - Fax:575-222-2288
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPA2019-0070363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant