Provider Demographics
NPI:1043394588
Name:BROWN, DEBRA E (FNP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:E
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:850 N HOSPITAL DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:FULTON
Mailing Address - State:MO
Mailing Address - Zip Code:65251-2535
Mailing Address - Country:US
Mailing Address - Phone:573-642-5338
Mailing Address - Fax:573-642-9224
Practice Address - Street 1:850 N HOSPITAL DR
Practice Address - Street 2:SUITE F
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251-2535
Practice Address - Country:US
Practice Address - Phone:573-642-5338
Practice Address - Fax:573-642-9224
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO149477RN363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO424447506Medicaid
MO772094OtherHEALTHLINK
MOP00601086Medicare PIN
MOP00408424Medicare PIN
Q73833Medicare UPIN
MO832051108Medicare PIN
MO424447506Medicaid