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General NPI Number Information
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NPI Number | 1164754008
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Entity Type | Individual
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Provider Name | DEBORAH J MOREAU FNP
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Gender | Female
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 1623 HOSPITAL LOOP RD
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City | OWYHEE
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State | NV
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Zip | 89832
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Country | US
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Telephone | 775-757-2415
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Fax | 775-757-3027
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Provider Business Mailing Address
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Address Line | 360 STILLWOOD DR
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City | MANCHESTER
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State | TN
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Zip | 37355-7343
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Country | US
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Telephone | 931-575-5286
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN0000014261
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3010321
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License Number State | KY
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