Provider Demographics
NPI:1205032919
Name:ELWELL, DEBRA KAY (FNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:KAY
Last Name:ELWELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:KAY
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:101 S. AVE T
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:TX
Mailing Address - Zip Code:76634
Mailing Address - Country:US
Mailing Address - Phone:254-675-8322
Mailing Address - Fax:254-675-8964
Practice Address - Street 1:101 S. AVE T
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:TX
Practice Address - Zip Code:76634-0549
Practice Address - Country:US
Practice Address - Phone:254-675-8322
Practice Address - Fax:254-675-8964
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX668926363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily