Healthcare Provider Details

I. General information

NPI: 1548381080
Provider Name (Legal Business Name): DEBORAH MAGNAN BRASIC F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH JEAN BRASIC F.N.P.

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1988 S 16TH ST
WILMINGTON NC
28401-6647
US

IV. Provider business mailing address

1988 S 16TH ST
WILMINGTON NC
28401-6647
US

V. Phone/Fax

Practice location:
  • Phone: 910-251-1839
  • Fax: 910-251-8286
Mailing address:
  • Phone: 910-251-1839
  • Fax: 910-251-8286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201491
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: