Provider Demographics
NPI:1346416765
Name:ROBERSON, DEBORAH BEAVERS (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:BEAVERS
Last Name:ROBERSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GUY RD
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-7206
Mailing Address - Country:US
Mailing Address - Phone:919-553-3900
Mailing Address - Fax:919-553-0395
Practice Address - Street 1:100 GUY RD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-7206
Practice Address - Country:US
Practice Address - Phone:919-553-3900
Practice Address - Fax:919-553-0395
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201379363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP06387Medicare UPIN