Basic Information
Provider Information
NPI: 1841482874
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GREGORY
FirstName: DEBORAH
MiddleName: ANNE
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1209
Address2:  
City: FRANKLIN
State: NC
PostalCode: 287440569
CountryCode: US
TelephoneNumber: 8282131500
FaxNumber: 8286516570
Practice Location
Address1: 190 RIVERVIEW ST
Address2:  
City: FRANKLIN
State: NC
PostalCode: 287342612
CountryCode: US
TelephoneNumber: 8283496804
FaxNumber: 8283496808
Other Information
ProviderEnumerationDate: 08/14/2007
LastUpdateDate: 11/25/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X228264-5004238NCN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363L00000X228264NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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