Provider Demographics
NPI:1720635444
Name:BEARD, DEBORAH LOVNNE
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LOVNNE
Last Name:BEARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14540 NW COUNTY ROAD 1001
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MO
Mailing Address - Zip Code:64720-4833
Mailing Address - Country:US
Mailing Address - Phone:816-835-4133
Mailing Address - Fax:
Practice Address - Street 1:14540 NW COUNTY ROAD 1001
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MO
Practice Address - Zip Code:64720-4833
Practice Address - Country:US
Practice Address - Phone:816-835-4133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider