Provider Demographics
NPI:1205163045
Name:SMITH, DEBORAH DAWN (NP)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:DAWN
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1901 HILLANDALE RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2664
Mailing Address - Country:US
Mailing Address - Phone:919-383-1854
Mailing Address - Fax:919-384-7089
Practice Address - Street 1:1901 HILLANDALE RD
Practice Address - Street 2:SUITE F
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2664
Practice Address - Country:US
Practice Address - Phone:919-383-1854
Practice Address - Fax:919-384-7089
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily