Individual
DEBRA K. FENTON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
750 OLD LUCERNE RD, UPPER LAKE, CA 95485-8755
(707) 275-9066
(707) 275-9070
Mailing address
5516 OAK RIDGE DR, KELSEYVILLE, CA 95451-9374
(707) 279-4489
(707) 275-9066
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
332923
CA
Other
Enumeration date
11/10/2005
Last updated
07/08/2007
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