Individual provider · NPI-1

Debra Inevia Fairless, APN

Nurse Practitioner, Family · Mena, AR

NPI number1285805358
StatusActive
Last updated in NPPESJul 6, 2011

Details

NPI
1285805358
Entity type
Individual (NPI-1)
Name
Mrs. Debra Inevia Fairless
Credential
APN
Sex
Female
Sole proprietor
No
Enumeration date
Mar 17, 2008
Last updated
Jul 6, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyA03080ANPARYes

Practice location

1210 Dequeen St
Mena, AR 71953-4132

Phone 479-394-5068 · Fax 479-394-5626

Mailing address

P.O. Box 1788
Mena, AR 71953-1781

Phone 479-394-5068 · Fax 479-394-5626

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