THERESA JANE DEBORD (NPI# 1134772353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134772353 |
| Entity Type | Individual |
| Full Name | THERESA JANE DEBORD |
| Credential | PMHNP-BC |
| Practice Address |
5835 State Route 154 # Address2 Pinckneyville IL 62274-3418 |
| Practice Telephone | 6183579722 |
| Mailing Telephone | 6183579722 |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
209019229 | IL | Nursing Service Providers |
| Street Address |
5835 STATE ROUTE 154 # ADDRESS2 |
| City | PINCKNEYVILLE |
| State | IL |
| Zip Code | 62274-3418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912260233 | Kathy Lynn Heard | Physical Therapy Assistant | 101 N. Walnut St., Pinckneyville, IL 62274 | 2012-06-21 |
| 1235254350 | Timothy Alan Mathis | Emergency Medicine | 202 S Walnut St, Pinckneyville, IL 62274 | 2007-03-20 |
| 1225194988 | Perry County Trans Van | Non-emergency Medical Transport (VAN) | 602 S Douglas St, Pinckneyville, IL 62274 | 2006-12-28 |
| 1063591261 | Medical Arts Sc | Family Medicine | 13 North Walnut Street, Pinckneyville, IL 62274 | 2006-11-06 |
| 1588670426 | Ralph Kane Chapman | Dentist | Box 469, 314 W South St, Pinckneyville, IL 62274 | 2006-07-31 |
| 1427456961 | Alisa D Dearmond | Nurse Practitioner | 5383 State Route 154, Pinckneyville, IL 62274 | 2014-12-16 |
| 1619210721 | Andrea Marie Epplin | Nurse Practitioner | 5383 State Route 154, Family Medical Center, Pinckneyville, IL 62274 | 2013-03-27 |
| 1841336799 | Clinic Pharmacy | Pharmacy | 206 North Main Street, Pinckneyville, IL 62274-0364 | 2007-01-29 |
| 1992840821 | Wayne Ray Hawkins | Dentist | 212 N Walnut St, Pinckneyville, IL 62274-1015 | 2007-02-20 |
| 1194384669 | Thaddeus Hawkins | Dentist | 212 N Walnut St, Pinckneyville, IL 62274-1015 | 2019-06-10 |
| Find all providers in zip 62274 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770101420 | Alissa Nichole Thompson | Registered Nurse | 2541 W Belden Ave Apt 1, Chicago, IL 60647-0482 | 2020-07-09 |
| 1548892565 | Sonja K Negrean | Registered Nurse | 280 Shuman Blvd, Naperville, IL 60563-8492 | 2020-02-07 |
| 1740740653 | Cherise C Rosen | Registered Nurse | 110 Frank Lloyd Wright Ln, Oak Park, IL 60302-2616 | 2019-03-25 |
| 1821589706 | Virginie Nyancho | Registered Nurse | 1336 Court Leona, Hanover Park, IL 60133-5419 | 2018-05-25 |
| 1861848681 | Merry Carlson | Registered Nurse | 1120 N Farnsworth Ave Apt 1d, Aurora, IL 60505-2049 | 2016-05-11 |
| 1801210273 | Robie Victoria Hughes | Registered Nurse | 310 W Losey Street, Scott Air Force Base, IL 62225 | 2014-02-06 |
| 1215360763 | Debra A Foppe | Registered Nurse | 19125 State Route 127, Carlyle, IL 62231-5303 | 2013-08-19 |
| 1871817742 | Bente Clausen | Registered Nurse | 715 Lake St Ste 720, Oak Park, IL 60301-1416 | 2010-03-22 |
| 1477887032 | Susan Leann Lear | Registered Nurse | 1001 N Market St Ste 101, Mount Carmel, IL 62863-1945 | 2009-09-29 |
| 1619179041 | Omotola Wasilat Danmole-odimayo | Registered Nurse | 5850 6th Street Frontage Rd E Ste A, Springfield, IL 62703-5194 | 2007-06-05 |
| Find all providers with the same taxonomy | ||||
| City | PINCKNEYVILLE |
| Zip Code | 62274 |
Please comment or provide details below to improve the information on THERESA JANE DEBORD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.