MEDICARE: DR. DEBORAH S FLOURNOY PHD, APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	232722	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00645	OTHER	TX	APRN PRESCRIBING NUMBER

General Provider Information

NPI Number	:	1235126467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH S FLOURNOY PHD, APRN

Provider Business Mailing Address
First Line	:	632 COUNTY ROAD 3008
Second Line	:
City	:	NEW BOSTON
State	:	TX
Zip	:	75570-6312
Country	:	US
Telephone Number	:	903-628-0041
Fax Number	:	903-628-0043

Provider Business Practice Location Address
First Line	:	304 W US HIGHWAY 82
Second Line	:
City	:	NEW BOSTON
State	:	TX
Zip	:	75570-2528
Country	:	US
Telephone Number	:	903-628-0041
Fax Number	:	903-628-0043

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	11/16/2010

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