Provider Demographics
NPI:1952368995
Name:TRIPP, DEBRA BOYETTE (FNP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:BOYETTE
Last Name:TRIPP
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 1:4320 GEORGETOWN DR N
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-8142
Mailing Address - Country:US
Mailing Address - Phone:252-237-5136
Mailing Address - Fax:
Practice Address - Street 1:2303 WELLINGTON DR SW
Practice Address - Street 2:SUITE A
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-8620
Practice Address - Country:US
Practice Address - Phone:252-237-5090
Practice Address - Fax:252-291-0393
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200853363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily