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NPI Code Detail

MEDICARE: DEBRA COBB MACK

MEDICARE: DEBRA COBB MACK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0808XPsychiatric/Mental Health Registered Nurse157119NC

General Provider Information

NPI Number : 1558296087
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA COBB MACK
Provider Business Mailing Address
First Line : 3300A SUMMIT AVE
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-3552
Country : US
Telephone Number : 336-303-2389
Fax Number :
Provider Business Practice Location Address
First Line : 3300A SUMMIT AVE
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-3552
Country : US
Telephone Number : 336-303-2389
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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Directions to “ DEBRA COBB MACK ” Practice Location

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