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NPI Code Detail

MEDICARE: DEBRA BAKER BEASLEY FNP

MEDICARE:   DEBRA BAKER BEASLEY  FNP
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
1363LF0000XFamily Nurse Practitioner200855NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1200855OTHERNCNC MEDICAL BOARD

General Provider Information

NPI Number : 1568458495
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA BAKER BEASLEY FNP
Provider Business Mailing Address
First Line : 5221 PARAMOUNT PKWY STE 220
Second Line :
City : MORRISVILLE
State : NC
Zip : 27560-5490
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4901 DAWN DR STE 3200
Second Line :
City : LUMBERTON
State : NC
Zip : 28360-8288
Country : US
Telephone Number : 910-735-8040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 12/12/2024

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Directions to “ DEBRA BAKER BEASLEY FNP” Practice Location

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