Debra E Brown, FNP
Individual provider Active NPI Nurse Practitioner · Fulton, MO
NPI 1043394588 · NPPES record last updated Jan 12, 2012
Key facts
- NPI
- 1043394588
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 149477RN (MO)
- Practice address
- 850 N Hospital Dr
Suite F
Fulton, MO 65251-2535 - Phone
- (573) 642-5338
- Fax
- (573) 642-9224
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149477RN | MO | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 149477RN | MO | Yes |
Addresses
Primary practice location
850 N Hospital Dr
Suite F
Fulton, MO 65251-2535
Mailing address
850 N Hospital Dr
Suite F
Fulton, MO 65251-2535
Phone (573) 642-5338
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 424447506 | Medicaid | MO | |
| 772094 | Other | MO | HEALTHLINK |
Other providers in Fulton, MO
- Brighter Day Health LLC
- Bristol Care, Inc.
- Bristol Care, Inc.
- Jennie L Brooks
- Brian Keith Brown
- John Edd Bucklew
- Callaway Chiropractic & Acupuncture Center, Inc.
- Callaway Counseling LLC
- Callaway County Ambulance District
- Callaway County Special Services
All providers in Fulton, MO · Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.