Provider Demographics
NPI:1871386631
Name:DEBOSE, REANNE ELIZABETH
Entity type:Individual
Prefix:
First Name:REANNE
Middle Name:ELIZABETH
Last Name:DEBOSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 71ST ST # 1111
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2294
Mailing Address - Country:US
Mailing Address - Phone:913-201-7871
Mailing Address - Fax:
Practice Address - Street 1:4501 71ST ST # 1111
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2294
Practice Address - Country:US
Practice Address - Phone:913-201-7871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program