Provider Demographics
NPI:1780894055
Name:LABRIE, DEBORAH DENICE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:DENICE
Last Name:LABRIE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11301 RUNNING DEER CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-8344
Mailing Address - Country:US
Mailing Address - Phone:405-623-6721
Mailing Address - Fax:
Practice Address - Street 1:3110 SW 89TH ST
Practice Address - Street 2:SUITE 200C
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7920
Practice Address - Country:US
Practice Address - Phone:405-759-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1060363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical