Healthcare Provider Details

I. General information

NPI: 1932261708
Provider Name (Legal Business Name): DEBORAH BOYETTE HERRING RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 GOVERNMENT CIR
GREENVILLE NC
27834-8198
US

IV. Provider business mailing address

4505 COREY RD
WINTERVILLE NC
28590-9271
US

V. Phone/Fax

Practice location:
  • Phone: 252-902-2305
  • Fax: 252-413-1446
Mailing address:
  • Phone: 252-756-4236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number058445
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: