Provider Demographics
NPI:1730350315
Name:TILL, DEBORAH JOAN (ANP)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:JOAN
Last Name:TILL
Suffix:
Gender:F
Credentials:ANP
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 E FIREWEED AVE
Mailing Address - Street 2:ALASKA VETERANS AND PIONEER HOME
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-6638
Mailing Address - Country:US
Mailing Address - Phone:907-745-4242
Mailing Address - Fax:907-745-0230
Practice Address - Street 1:250 E FIREWEED AVE
Practice Address - Street 2:ALASKA VETERANS AND PIONEER HOME
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-6638
Practice Address - Country:US
Practice Address - Phone:907-745-4242
Practice Address - Fax:907-745-0230
Is Sole Proprietor?:No
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK15140-269363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily