Provider Demographics
NPI:1578841375
Name:DESBIEN, PERRY WILLIAM (MSN)
Entity Type:Individual
Prefix:MR
First Name:PERRY
Middle Name:WILLIAM
Last Name:DESBIEN
Suffix:
Gender:M
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:GOODLAND
Mailing Address - State:KS
Mailing Address - Zip Code:67735-1602
Mailing Address - Country:US
Mailing Address - Phone:785-890-3625
Mailing Address - Fax:
Practice Address - Street 1:220 W 2ND ST
Practice Address - Street 2:
Practice Address - City:GOODLAND
Practice Address - State:KS
Practice Address - Zip Code:67735-1602
Practice Address - Country:US
Practice Address - Phone:785-890-3625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSTMP 143228363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily