Individual
NIKKI DEBORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1314 19TH AVE, MERIDIAN, MS 39301-4116
(601) 483-0011
Mailing address
1314 19TH AVE, MERIDIAN, MS 39301-4116
(601) 483-0011
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33751
MS
207Q00000X
Family Medicine Physician
342899
LA
Other
Enumeration date
06/09/2021
Last updated
09/25/2024
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