Provider Demographics
NPI:1164657672
Name:JOHNS, DEBORAH (OGNP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:JOHNS
Suffix:
Gender:F
Credentials:OGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8220 UNIVERSITY EXEC PARK DR
Mailing Address - Street 2:STE 107
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-3380
Mailing Address - Country:US
Mailing Address - Phone:704-548-1221
Mailing Address - Fax:704-548-1311
Practice Address - Street 1:8220 UNIVERSITY EXEC PARK DR
Practice Address - Street 2:STE 107
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-3380
Practice Address - Country:US
Practice Address - Phone:704-548-1221
Practice Address - Fax:704-548-1311
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC800116363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology