Basic Information
Provider Information | |||||||||
NPI: | 1184026130 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | TOWERY | ||||||||
FirstName: | DEBRA | ||||||||
MiddleName: | ELAINE | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | FNP-BC | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | TOWERY | ||||||||
OtherFirstName: | DEBRA | ||||||||
OtherMiddleName: | MORRIS | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | FNP-C | ||||||||
OtherLastNameType: | 5 | ||||||||
Mailing Information | |||||||||
Address1: | 144 RESERVATION DR | ||||||||
Address2: |   | ||||||||
City: | SPINDALE | ||||||||
State: | NC | ||||||||
PostalCode: | 281601566 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8282870200 | ||||||||
FaxNumber: | 8282878755 | ||||||||
Practice Location | |||||||||
Address1: | 144 RESERVATION DR | ||||||||
Address2: |   | ||||||||
City: | SPINDALE | ||||||||
State: | NC | ||||||||
PostalCode: | 281601566 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8282870200 | ||||||||
FaxNumber: | 8282878755 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/22/2014 | ||||||||
LastUpdateDate: | 12/15/2014 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 5007220 | NC | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |   |
ID Information
ID | Type | State | Issuer | Description | MT330594 | 01 |   | DEA | OTHER |