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Individual

MRS. DEBORAH J VENCILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3950 17TH ST, SUITE A, BAKER CITY, OR 97814-1300
(541) 523-1001
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
079042283N1
OR

Other

Enumeration date
10/11/2005
Last updated
09/18/2012
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