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: 05/15/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S. 169 HWY
SMITHVILLE MO
64089
US

IV. Provider business mailing address

12330 FOX CREEK DR
PLATTE CITY MO
64079-9276
US

V. Phone/Fax

Practice location:
  • Phone: 816-532-7236
  • Fax:
Mailing address:
  • Phone: 337-305-5620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2021024191
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: