Provider Demographics
NPI:1659699700
Name:PERRY, DEBORAH S (CPM)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:PERRY
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13211 CRYSTAL AVE
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030-3336
Mailing Address - Country:US
Mailing Address - Phone:832-215-3403
Mailing Address - Fax:
Practice Address - Street 1:13211 CRYSTAL AVE
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030-3336
Practice Address - Country:US
Practice Address - Phone:832-215-3403
Practice Address - Fax:816-298-1330
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
07080003OtherNARM CERTIFICATION