Provider Demographics
NPI:1760617757
Name:SPELL, DEBORAH MILLEN
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:MILLEN
Last Name:SPELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1295
Mailing Address - Street 2:
Mailing Address - City:ROSEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28382-1295
Mailing Address - Country:US
Mailing Address - Phone:910-531-4097
Mailing Address - Fax:
Practice Address - Street 1:201 W CLINTON ST
Practice Address - Street 2:
Practice Address - City:ROSEBORO
Practice Address - State:NC
Practice Address - Zip Code:28382-6610
Practice Address - Country:US
Practice Address - Phone:910-531-4097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other