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DEBRA K. FENTON NP
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1316928807
Individual Registrant: DEBRA K. FENTON NP
Gender: F
Gender: F
Location and contact information for practice:
750 OLD LUCERNE RD UPPER LAKE, CA 95485-8755 US
Tel: 707-275-9066 Fax: 707-275-9070
Tel: 707-275-9066 Fax: 707-275-9070
Contact information for business:
5516 OAK RIDGE DR KELSEYVILLE, CA 95451-9374 US
Tel: 707-279-4489 Fax: 707-275-9066
Tel: 707-279-4489 Fax: 707-275-9066
Registration Information:
NPI: 1316928807
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | CA | 332923 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
