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General NPI Number Information
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NPI Number | 1184957516
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Entity Type | Individual
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Provider Name | MS. DEBORAH K JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 09/17/2009
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Last Update Date | 05/27/2010
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Provider Practice Location Address
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Address Line | 111 HOSPITAL DR
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City | TARBORO
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State | NC
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Zip | 27886-2011
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Country | US
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Telephone | 252-641-7229
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Fax | 252-641-7388
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Provider Business Mailing Address
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Address Line | 360 CORBETT RD
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City | GOLDSBORO
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State | NC
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Zip | 27534-7910
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Country | US
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Telephone | 919-778-0140
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 65826
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 083018
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License Number State | NC
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