Individual
MRS. HATTIE DEBORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
12 JEFFERSON SQ, DE SOTO, MO 63020-1031
(636) 586-6685
Mailing address
12 JEFFERSON SQ, DE SOTO, MO 63020-1031
(636) 586-6685
(636) 586-2780
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2012033866
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2022029288
MO
Other
Enumeration date
10/12/2012
Last updated
05/08/2024
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