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General NPI Number Information
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NPI Number | 1134708753
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Entity Type | Individual
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Provider Name | DEBBRA LYNN FORRESTER FNP
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Gender | Female
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Dates
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Enumeration Date | 04/02/2021
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | 218 N PINE STREET
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City | BAKER CITY
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State | OR
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Zip | 97814
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Country | US
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Telephone | 541-742-5023
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Fax | 541-742-7210
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Provider Business Mailing Address
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Address Line | PO BOX 994
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City | BAKER CITY
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State | OR
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Zip | 97814-0994
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Country | US
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Telephone | 541-519-6044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 202008828NP-PP
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License Number State | OR
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