Brianne Nicole Deboer, FNP
Individual provider Active NPI Family Nurse Practitioner · Richland, MI
NPI 1982175741 · NPPES record last updated Jul 20, 2020
Key facts
- NPI
- 1982175741
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704245738 (MI)
- Practice address
- 8450 N 32ND St
Richland, MI 49083-9418 - Phone
- (269) 552-2500
- NPI assigned
- Dec 5, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200630002226 | MI | Practitioner - Nurse Practitioner | 4385067875 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704245738 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension Medical Group Promed | Family | Current |
Accepting new patients |
| Promed Healthcare | Current |
Accepting new patients |
Locations
1717 Shaffer St
Ste 002
Kalamazoo, MI 49048
7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405
8450 N 32nd St
Richland, MI 49083
Phone (269) 226-2500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704245738 | MI | Yes |
Addresses
Primary practice location
8450 N 32ND St
Richland, MI 49083-9418
Mailing address
9667 N 42ND St
Hickory Corners, MI 49060-9510
Phone (269) 830-2087
Other providers in Richland, MI
- Dawn Coeur
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- Comprehensive Psychological and Assessment Services, LLC
- Jason Michael Corradini
- Cheryl Czerney
- Sandra Dejong
- Emily E Derhammer
- Maribel Xiomara Diaz-Munoz-Laforge
- Ashley Elizabeth Diehl
- Linda Dolbee
All providers in Richland, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.