Provider Demographics
NPI:1558734152
Name:ROUSE, DEBRA JEANNE (ND)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:JEANNE
Last Name:ROUSE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1153 BERGEN PKWY
Mailing Address - Street 2:I-458
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-9501
Mailing Address - Country:US
Mailing Address - Phone:303-909-6139
Mailing Address - Fax:
Practice Address - Street 1:32007 FOX RUN LN
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-2604
Practice Address - Country:US
Practice Address - Phone:303-674-6139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COND000017175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath