Basic Information
| Provider Information | |||||||||
| NPI: | 1982633111 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUTSHALL | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | JEAN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1803 MOUNT ROSE AVE | ||||||||
| Address2: | SUITE B3 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178511405 | ||||||||
| FaxNumber: | 7178123499 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 EDGAR ST | ||||||||
| Address2: | SUITE E | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174032862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178124602 | ||||||||
| FaxNumber: | 7178123499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2006 | ||||||||
| LastUpdateDate: | 06/13/2016 | ||||||||
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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 | 363LX0001X | TP003883G | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 102278 | 01 | PA | JOHNS HOPKINS | OTHER | 1551152 | 01 | PA | GATEWAY-YH | OTHER | 647489 | 01 | MD | CAREFIRST MD BCBS | OTHER | 50053262 | 01 | PA | CAPITAL BLUE CROSS-YH | OTHER |