Healthcare Provider Details

I. General information

NPI: 1215299482
Provider Name (Legal Business Name): DEBORAH BERNICE BESTE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 06/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 E 5TH ST SUITE 200
WASHINGTON MO
63090-3135
US

IV. Provider business mailing address

851 E 5TH ST SUITE 200
WASHINGTON MO
63090-3135
US

V. Phone/Fax

Practice location:
  • Phone: 636-239-8585
  • Fax: 636-239-8552
Mailing address:
  • Phone: 636-239-8585
  • Fax: 636-239-8552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2010007619
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: