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Organization
COASTAL RIDGE HEALTH SERVICES, PLLC
Active
Organization
COASTAL RIDGE HEALTH SERVICES, PLLC
Active
Other names
Deborah Jenks
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBORAH S JENKS DNP, PMHNP-BC, FNP (OWNER/EXECUTIVE DIRECTOR)
(910) 821-1418
Entity
Organization
Contact information
Practice address
14057 US HIGHWAY 17 STE 200, HAMPSTEAD, NC 28443-3793
(910) 821-1418
(866) 860-0997
Mailing address
14057 US HIGHWAY 17 STE 200, HAMPSTEAD, NC 28443-3793
(910) 821-1418
(866) 860-0997
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
4461S
NC
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024175505
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5009986
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024175505
VIRGINIA NP NUMBER
VA
01
—
4461S
NORTH CAROLINA BOARD OF PROFESSIONAL COUNSELORS
NC
01
—
5009986
NORTH CAROLINA LICENSE NUMBER
NC
Enumeration date
08/10/2018
Last updated
01/11/2023
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