Individual
MRS. DEBORAH ANN HARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN,APRN FNP-C
Contact information
Practice address
105 CREEKSIDE OFFICE DR, WENTZVILLE, MO 63385-3289
(636) 639-6262
Mailing address
105 CREEKSIDE OFFICE DR, WENTZVILLE, MO 63385-3289
(636) 639-6262
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2013030779
MO
363L00000X
Nurse Practitioner
Primary
F0813261
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275960254
—
MO
Enumeration date
10/04/2013
Last updated
10/21/2015
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