Provider Demographics
NPI:1962286344
Name:FORE, DEBORAH (FNP-C)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:FORE
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 STONE FORREST TRL
Mailing Address - Street 2:
Mailing Address - City:MC HENRY
Mailing Address - State:MS
Mailing Address - Zip Code:39561-5201
Mailing Address - Country:US
Mailing Address - Phone:228-669-1418
Mailing Address - Fax:
Practice Address - Street 1:3890 BIENVILLE BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-5803
Practice Address - Country:US
Practice Address - Phone:228-872-7600
Practice Address - Fax:228-875-3385
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily