Provider Demographics
NPI:1851398044
Name:FREELS, DEBBIE L (RN, MSN, FNP-BC, CNM)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:L
Last Name:FREELS
Suffix:
Gender:F
Credentials:RN, MSN, FNP-BC, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 BURKARTH RD
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-3101
Mailing Address - Country:US
Mailing Address - Phone:660-563-5555
Mailing Address - Fax:660-563-5558
Practice Address - Street 1:600 E ALLEN ST STE A
Practice Address - Street 2:
Practice Address - City:KNOB NOSTER
Practice Address - State:MO
Practice Address - Zip Code:65336
Practice Address - Country:US
Practice Address - Phone:660-563-5555
Practice Address - Fax:660-563-5558
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO121074367A00000X
MO2011036528363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
420001811OtherRAILROAD MEDICARE
MO42283OtherHEALTHCARE USA
MO258909639Medicaid
MO258909639OtherMISSOURICARE
MO258909639OtherMISSOURICARE
726C220DMedicare ID - Type Unspecified