Provider Demographics
NPI:1235126467
Name:FLOURNOY, DEBORAH S (PHD, APRN)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:S
Last Name:FLOURNOY
Suffix:
Gender:F
Credentials:PHD, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 COUNTY ROAD 3008
Mailing Address - Street 2:
Mailing Address - City:NEW BOSTON
Mailing Address - State:TX
Mailing Address - Zip Code:75570-6312
Mailing Address - Country:US
Mailing Address - Phone:903-628-0041
Mailing Address - Fax:903-628-0043
Practice Address - Street 1:304 W US HIGHWAY 82
Practice Address - Street 2:
Practice Address - City:NEW BOSTON
Practice Address - State:TX
Practice Address - Zip Code:75570-2528
Practice Address - Country:US
Practice Address - Phone:903-628-0041
Practice Address - Fax:903-628-0043
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX232722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00645OtherAPRN PRESCRIBING NUMBER
TXS57641Medicare UPIN
TX8C8354Medicare ID - Type Unspecified