Provider Demographics
NPI:1346266038
Name:PHILLIPS, DEBORAH B (C-FNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:B
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:C-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 BRIDGES ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-3330
Mailing Address - Country:US
Mailing Address - Phone:252-727-4933
Mailing Address - Fax:252-727-4936
Practice Address - Street 1:3004 BRIDGES ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-3330
Practice Address - Country:US
Practice Address - Phone:252-727-4933
Practice Address - Fax:252-727-4936
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7003787Medicaid
NC7003787Medicaid
NCS55094Medicare UPIN