Healthcare Provider Details

I. General information

NPI: 1285180984
Provider Name (Legal Business Name): DEBORAH STEPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 BUTTERCUP DR
MOUNTAIN HOME AR
72653-2910
US

IV. Provider business mailing address

PO BOX 46
LAKEVIEW AR
72642-0046
US

V. Phone/Fax

Practice location:
  • Phone: 870-425-3030
  • Fax: 870-425-0633
Mailing address:
  • Phone: 870-421-6830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA004890
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: