Deborah Colleen Shouse, RN, BC, FNP

Individual provider Active NPI Family Nurse Practitioner · Paris, MO

NPI 1508949413 · NPPES record last updated Nov 27, 2023

Key facts

NPI
1508949413
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
065464 (MO)
Practice address
102 E Marion St
Paris, MO 65275-1041
Phone
(660) 327-4911
Fax
(660) 327-5501
NPI assigned
Oct 23, 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, Registered Nurse

State licenses

LicenseStateTypeSpecialty
065464MOMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 065464 MO Yes

Addresses

Primary practice location

102 E Marion St
Paris, MO 65275-1041

Mailing address

102 E Marion St
Paris, MO 65275-1041
Phone (660) 327-4911

Other identifiers

IdentifierTypeStateIssuer
425891603MedicaidMO
065464OtherMORN NP LICENSE #

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Other providers in Paris, MO

All providers in Paris, MO · Family Nurse Practitioner in Missouri

Sources for this page

Verify at the official NPI Registry.