Individual
DEBRA A HOERTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
120 HOSPITAL DR, LEBANON, MO 65536-9238
(417) 533-6100
Mailing address
758 N DOGWOOD CT, NIXA, MO 65714-7216
(503) 369-7978
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
151783
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100381010B
—
KS
01
—
145411
BCBS OF KS
KS
01
—
P00398983
RR MEDICARE GROUP CQ2302
KS
Enumeration date
11/03/2005
Last updated
03/29/2012
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