Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 930176 | NC |
N | 363LP0222X | Nurse Practitioner Pediatrics (Critical Care) | 930176 | NC |
NPI | 1063786952 |
---|---|
Provider Name | Mrs. Deborah Terry Tabb |
First Address | Greensboro, NC 27408-7021 |
Second Address | Greensboro, NC 27408-7021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2012 |
Last Update Date | 24/02/2012 |