Provider Demographics
NPI:1043323611
Name:KASS, DEBORAH (NP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:KASS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1150 STATE HIGHWAY 248
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-3758
Mailing Address - Country:US
Mailing Address - Phone:417-336-4112
Mailing Address - Fax:417-335-4684
Practice Address - Street 1:1150 STATE HIGHWAY 248
Practice Address - Street 2:SUITE 100
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-3758
Practice Address - Country:US
Practice Address - Phone:417-336-4112
Practice Address - Fax:417-335-4684
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2017-01-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAAPRN523825363LP0808X
CA523825364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ29902Medicare UPIN