Healthcare Provider Details

I. General information

NPI: 1831113570
Provider Name (Legal Business Name): DEBORA G. BARNES WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 E INDEPENDENCE ST STE B
SPRINGFIELD MO
65804-4213
US

IV. Provider business mailing address

1335 E INDEPENDENCE ST STE B
SPRINGFIELD MO
65804-4213
US

V. Phone/Fax

Practice location:
  • Phone: 417-881-8818
  • Fax: 417-886-9836
Mailing address:
  • Phone: 417-881-8818
  • Fax: 417-886-9836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number090547
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: