Healthcare Provider Details

I. General information

NPI: 1710816723
Provider Name (Legal Business Name): DEBORAH L FENTON MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBBIE FENTON MSN

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 S ELIZABETH ST STE 200
INDEPENDENCE MO
64057-1785
US

IV. Provider business mailing address

12330 FOX CREEK DR
PLATTE CITY MO
64079-9276
US

V. Phone/Fax

Practice location:
  • Phone: 816-768-0090
  • Fax: 816-912-1739
Mailing address:
  • Phone: 337-305-5620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2026035381
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: