Individual
MS. DEBORAH SUE HARGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
700 W MARKET ST, ATHENS, AL 35611-2457
(256) 262-2112
Mailing address
PO BOX 999, ATHENS, AL 35612-0999
(256) 262-2112
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-095801
AL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1-095801
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511-56057
BCBS
AL
Enumeration date
01/18/2008
Last updated
01/11/2016
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