Provider Demographics
NPI:1871705921
Name:DITTO, DEBORAH LYNN (MSN, CNM)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LYNN
Last Name:DITTO
Suffix:
Gender:F
Credentials:MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10156 GILLESPIE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:TN
Mailing Address - Zip Code:38002-8282
Mailing Address - Country:US
Mailing Address - Phone:901-867-7371
Mailing Address - Fax:
Practice Address - Street 1:1660 BONNIE LN
Practice Address - Street 2:SUITE 105
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-0518
Practice Address - Country:US
Practice Address - Phone:901-888-1000
Practice Address - Fax:901-888-1001
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000008144367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife