Provider Demographics
NPI:1508820457
Name:MEESE, DEBRA ANN (OD, PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:ANN
Last Name:MEESE
Suffix:
Gender:F
Credentials:OD, PHD
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 308
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:CO
Mailing Address - Zip Code:81631-0308
Mailing Address - Country:US
Mailing Address - Phone:970-485-4948
Mailing Address - Fax:
Practice Address - Street 1:232 BROADWAY STREET
Practice Address - Street 2:X5529
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631-5529
Practice Address - Country:US
Practice Address - Phone:970-926-7773
Practice Address - Fax:970-945-9793
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-15
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH0787152W00000X
VT030-0000341152W00000X
CO2889152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE859001Medicare PIN