Provider Demographics
NPI:1164475240
Name:LOMBARDI, DEBORAH WEATHERS (PMHCNS, BC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:WEATHERS
Last Name:LOMBARDI
Suffix:
Gender:F
Credentials:PMHCNS, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10616 METROMONT PKWY
Mailing Address - Street 2:SUITE 208
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-7656
Mailing Address - Country:US
Mailing Address - Phone:704-641-3213
Mailing Address - Fax:704-641-3213
Practice Address - Street 1:10616 METROMONT PKWY
Practice Address - Street 2:SUITE 208
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-7656
Practice Address - Country:US
Practice Address - Phone:704-641-3213
Practice Address - Fax:704-641-3213
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC077464163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2819772Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO.