Provider Demographics
NPI:1053506154
Name:KELTY, DEBORAH D (RNFA)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:D
Last Name:KELTY
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:D
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNFA
Mailing Address - Street 1:2495 OLD VINCENNES ROAD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-5494
Mailing Address - Country:US
Mailing Address - Phone:502-499-2197
Mailing Address - Fax:
Practice Address - Street 1:2495 OLD VINCENNES RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-5494
Practice Address - Country:US
Practice Address - Phone:502-499-2197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1048311163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant