Healthcare Provider Details

I. General information

NPI: 1730146408
Provider Name (Legal Business Name): DEBRA SUE LUMBLEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBRA RIEMANN CRNA

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 03/08/2024
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N KENTUCKY AVE
WEST PLAINS MO
65775-2029
US

IV. Provider business mailing address

1340 WOLF CREEK RD
GOREVILLE IL
62939-2031
US

V. Phone/Fax

Practice location:
  • Phone: 573-803-5206
  • Fax:
Mailing address:
  • Phone: 870-882-2239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209021283
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberC01387
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2023047203
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: