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General NPI Number Information
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NPI Number | 1710955406
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Entity Type | Individual
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Provider Name | DEBRA C. PANKAU FNP
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Gender | Female
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 305 RHODE ISLAND
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City | KING CITY
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State | MO
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Zip | 64463-0278
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Country | US
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Telephone | 660-535-4347
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Fax | 660-535-6240
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Provider Business Mailing Address
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Address Line | 2303 VILLAGE DR
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-4954
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Country | US
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Telephone | 816-232-6818
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Fax | 816-232-2991
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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 | 103547
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License Number State | MO
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