Provider Demographics
NPI:1417580770
Name:VEST, DEBORAH ELIZABETH (CCN, RN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ELIZABETH
Last Name:VEST
Suffix:
Gender:F
Credentials:CCN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 903
Mailing Address - Street 2:
Mailing Address - City:PILOT POINT
Mailing Address - State:TX
Mailing Address - Zip Code:76258-0903
Mailing Address - Country:US
Mailing Address - Phone:940-206-4848
Mailing Address - Fax:
Practice Address - Street 1:1850 N SAINT CHARLES AVE
Practice Address - Street 2:
Practice Address - City:PILOT POINT
Practice Address - State:TX
Practice Address - Zip Code:76258-2711
Practice Address - Country:US
Practice Address - Phone:940-206-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX510434163W00000X
TX5072133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No163W00000XNursing Service ProvidersRegistered Nurse