| Doctor Name: | DEBRA LANE FATHERREE |
| NPI Number: | 1053759621 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, IBCLC |
| License Number: | R715956 |
| Business Practice Address: | 1026 North Flowood Drive Flowood, MS - 39232 |
| Business Phone Number: | 6019336464 |
| Business Fax Number: | |
| Mailing Address: | 30 Westridge Drive, BRANDON |
| State: | MS |
| Postal Code: | 39047 |
| Phone Number: | 6016720025 |
| Fax Number: | |
| NPI Enumeration Date: | 06/05/2013 |
| NPI Last Update Date: | 06/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WL0100X |
| License Number: | R715956 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Lactation Consultant |
| Taxonomy Definition: | |