Provider Demographics
NPI:1538161328
Name:ROSSELL, DEBRA JEAN (RN MSN CFNP)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:JEAN
Last Name:ROSSELL
Suffix:
Gender:F
Credentials:RN MSN CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GUN BARRREL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75156
Mailing Address - Country:US
Mailing Address - Phone:903-887-6252
Mailing Address - Fax:
Practice Address - Street 1:801 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GUN BARREL CITY
Practice Address - State:TX
Practice Address - Zip Code:75156-5312
Practice Address - Country:US
Practice Address - Phone:903-887-6252
Practice Address - Fax:903-887-3668
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246212363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1212508-05Medicaid
TXNP0164OtherBC/BS
TX1212508-04Medicaid