Healthcare Provider Details

I. General information

NPI: 1760499727
Provider Name (Legal Business Name): DEBRA MCMEHAN PARKER CNNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W 27TH ST
LUMBERTON NC
28358-3075
US

IV. Provider business mailing address

10025 S 177TH ST
OMAHA NE
68136-1968
US

V. Phone/Fax

Practice location:
  • Phone: 910-671-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number930041
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number110477
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number930041
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: