Livingston-Green, Debra Lane

Livingston-Green, Debra Lane is an individual health care provider with primary practice located at 39 Office Park Dr Ste A , Jacksonville NC 28546-3220. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Livingston-Green, Debra Lane can be contacted via phone (910) 939-0724.

Contact Information

Primary practice address
39 Office Park Dr Ste A Jacksonville NC 28546-3220
Phone: (910) 939-0724
Fax: (939) 333-9145
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 91472 North Carolina

Profile Details

NPI number 1164724688
LBN Legal business name Livingston-Green, Debra Lane
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2010
Last updated Dec 20th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164724688 NPPES
North Carolina MEDICAID 6003101

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