Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 2008-00920 | NC |
NPI | 1316956063 |
---|---|
Provider Name | Dr. Debra L Blue |
First Address | Fuquay Varina, NC 27526-7389 |
Second Address | Raleigh, NC 27607-6372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 29/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F25144 | (02) |