1851398044 NPI number — DEBBIE L. FREELS RN, MSN, FNP-BC, CNM

Table of content: DEBBIE L. FREELS RN, MSN, FNP-BC, CNM (NPI 1851398044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851398044 NPI number — DEBBIE L. FREELS RN, MSN, FNP-BC, CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FREELS
Provider First Name:
DEBBIE
Provider Middle Name:
L.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN, MSN, FNP-BC, CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851398044
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
403 BURKARTH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARRENSBURG
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64093-3101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
660-563-5555
Provider Business Mailing Address Fax Number:
660-563-5558

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 E ALLEN ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOB NOSTER
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-563-5555
Provider Business Practice Location Address Fax Number:
660-563-5558
Provider Enumeration Date:
07/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367A00000X , with the licence number:  121074 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 2011036528 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 420001811 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 42283 . This is a "HEALTHCARE USA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 258909639 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 258909639 . This is a "MISSOURICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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