Healthcare Provider Details

I. General information

NPI: 1194706937
Provider Name (Legal Business Name): DEBORAH RUTH VERBEEK CFNP, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 12/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25495 MAIN ST
ARDMORE TN
38449-3155
US

IV. Provider business mailing address

25495 MAIN ST PO BOX 746
ARDMORE TN
38449-3155
US

V. Phone/Fax

Practice location:
  • Phone: 931-427-6969
  • Fax: 931-427-6967
Mailing address:
  • Phone: 931-427-6969
  • Fax: 931-427-6967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN0000095893
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: