| Debra Minor-schork Llc | |
|
504 East Elizabeth Street Suite 8 Elizabeth City NC 27909-4404 | |
| (252) 526-8833 | |
| (252) 482-7462 |
| Full Name | Debra Minor-schork Llc |
|---|---|
| Speciality | Counselor |
| Location | 504 East Elizabeth Street, Elizabeth City, North Carolina |
| Authorized Official Name and Position | Debra Lynne Minor-schork (CLINICAL NURSE SPECIALIST) |
| Authorized Official Contact | 2526324063 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Debra Minor-schork Llc 119 Montpelier Drive Edenton NC 27932-8909 Ph: (125) 263-2406 | Debra Minor-schork Llc 504 East Elizabeth Street Suite 8 Elizabeth City NC 27909-4404 Ph: (252) 526-8833 |
| NPI Number | 1285803668 |
|---|---|
| Provider Enumeration Date | 02/29/2008 |
| Last Update Date | 02/29/2008 |
| Medicare PECOS PAC ID | 1759466220 |
|---|---|
| Medicare Enrollment ID | O20080307000250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285803668 | NPI | - | NPPES |
| 6004040 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 100093 (North Carolina) | Primary |
| Provider Name | Debra L Minor-schork |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1003888306 PECOS PAC ID: 5496830960 Enrollment ID: I20080307000240 |
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