Provider Demographics
NPI:1982601498
Name:CYPHERT, DEBRA L (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:L
Last Name:CYPHERT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 W 21ST ST
Mailing Address - Street 2:SUITE E3
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-4087
Mailing Address - Country:US
Mailing Address - Phone:575-769-2533
Mailing Address - Fax:575-769-1735
Practice Address - Street 1:2000 W 21ST ST
Practice Address - Street 2:SUITE E3
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-4087
Practice Address - Country:US
Practice Address - Phone:575-769-2533
Practice Address - Fax:575-769-1735
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR31359363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM79785557Medicaid
NM341430124Medicare ID - Type Unspecified
NMQ26894Medicare UPIN