Deborah Kayteen Mulligan, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

5101014437 Issued in MI

Practice address

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9756

Phone

(616) 364-4200

Fax

(616) 364-7347

NPI assigned

Feb 27, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Deborah Kayteen Hervey Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1881660041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259756",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259756",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIGAN",
        "first_name": "DEBORAH",
        "middle_name": "KAYTEEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "5101014437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4230896",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "5410226",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "HERVEY",
            "middle_name": "KAYTEEN",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hannah Muller
• Henry Andrew Muller, MA LLPC
• Christian Henry Mullett, L.AC
• Shannon M Mullett, LMSW, CAADC
• Crystal Mulligan
• Emiel Murphy Mulligan
• Mary Patricia Mullin, DNP, FNP-BC, RN
• Marianne Mullins-Macritchie
• Anthony Mullins
• Justin Mullins

• Anesthesiology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Anesthesiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.