Provider Demographics
NPI:1467442608
Name:MEYERS, DEBORAH BRILL (MS NP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:BRILL
Last Name:MEYERS
Suffix:
Gender:F
Credentials:MS NP
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:BRILL
Other - Last Name:GRAUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:72 SUTTLE ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-6829
Mailing Address - Country:US
Mailing Address - Phone:970-403-8812
Mailing Address - Fax:
Practice Address - Street 1:72 SUTTLE ST
Practice Address - Street 2:SUITE C
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-6829
Practice Address - Country:US
Practice Address - Phone:970-403-8812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2015-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO56835363LA2200X, 363LP0200X
NMR37166364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCN7766Medicare PIN
CO500029105Medicare PIN
COP17854Medicare UPIN