Individual
DEBORAH L. GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.N.P.
Contact information
Practice address
1204 W MAIN ST, CHARLOTTESVILLE, VA 22903-2824
(434) 924-0123
(434) 243-3300
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024141256
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010216419
—
VA
01
—
C06115
GROUP PTAN
VA
Enumeration date
03/16/2007
Last updated
08/09/2023
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