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Individual

DEBORAH JACKSON WARREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN,FNP

Contact information

Practice address
307 W CORNELIUS HARNETT BLVD, LILLINGTON, NC 27546-9335
(910) 814-6280
(910) 893-9429
Mailing address
195 SANDY RIDGE RD, DUNN, NC 28334-8870
(910) 892-2148
(910) 893-9429

Taxonomy

Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
200304
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
07212
BCBSNC
NC
01
183296
MEDCOST
NC
05
NC3404343
NC
05
NC3404456
NC
Enumeration date
02/08/2007
Last updated
07/08/2007
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