Active NPI
Debra Conner, R.N.
- Registered Nurse
- Elizabethtown, NC
National Provider Identifier
1609938562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 106280
- Practice address
- 300 Mercer Road
Elizabethtown, NC 28337 - Phone
- (910) 862-6900
- Fax
- (910) 862-6859
- NPI assigned
- Dec 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 106280 | NC | Primary |
Addresses
Primary practice location
300 Mercer Road
Elizabethtown, NC 28337
Mailing address
300 Mercer Road
Elizabethtown, NC 28337
Phone (910) 862-6900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC29 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106280 | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609938562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 MERCER ROAD",
"city": "ELIZABETHTOWN",
"state": "NC",
"postal_code": "28337",
"telephone_number": "910-862-6900",
"fax_number": "910-862-6859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 MERCER ROAD",
"city": "ELIZABETHTOWN",
"state": "NC",
"postal_code": "28337",
"telephone_number": "910-862-6900",
"fax_number": "910-862-6859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNER",
"first_name": "DEBRA",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "106280",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DC29",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.