Healthcare Provider Details

I. General information

NPI: 1558283903
Provider Name (Legal Business Name): DEBRA JO BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 W MUELLER
PARAGOULD AR
72450-5041
US

IV. Provider business mailing address

612 W MUELLER
PARAGOULD AR
72450-5041
US

V. Phone/Fax

Practice location:
  • Phone: 870-240-2211
  • Fax: 870-240-2213
Mailing address:
  • Phone: 870-240-2211
  • Fax: 870-240-2213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberL038192
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: