Healthcare Provider Details

I. General information

NPI: 1871991034
Provider Name (Legal Business Name): DEBRA M STONE-CASPER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2014
Last Update Date: 12/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2093 US HIGHWAY 67
FESTUS MO
63028-3669
US

IV. Provider business mailing address

2093 US HIGHWAY 67
FESTUS MO
63028-3669
US

V. Phone/Fax

Practice location:
  • Phone: 636-937-7507
  • Fax: 636-937-7597
Mailing address:
  • Phone: 636-937-7507
  • Fax: 636-937-7597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number143407
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number143407
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: