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COASTAL RIDGE HEALTH SERVICES PLLC NPI 1487133351


NPI Information

NPI: 1487133351
Provider Name: COASTAL RIDGE HEALTH SERVICES, PLLC

Former Legal Business Name: DEBORAH JENKS

Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
14057 US HIGHWAY 17 STE 200
HAMPSTEAD, NC
ZIP 28443
Phone: (910) 821-1418
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COASTAL RIDGE HEALTH SERVICES, PLLC is a psychiatric/mental health nurse practitioner in Hampstead, NC. COASTAL RIDGE HEALTH SERVICES, PLLC NPI is 1487133351. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Deborah Jenks.

The provider's business location address is:

14057 US HIGHWAY 17 STE 200
HAMPSTEAD, NC
ZIP 28443-793
Phone: (910) 821-1418
Fax: (866) 860-0997

The provider's authorized official is Deborah S Jenks .
The authorized official title is Owner/executive Director and has the following contact phone number (910) 821-1418.

The enumeration date for this NPI number is 8/10/2018 and was last updated on 1/11/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyNo
2363LP0808XNurse PractitionerPsychiatric/Mental Health5009986NORTH CAROLINANo
3101YP2500XCounselorProfessional4461SNORTH CAROLINANo
4363LP0808XNurse PractitionerPsychiatric/Mental Health0024175505VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10024175505OTHERVIRGINIAVIRGINIA NP NUMBER
24461SOTHERNORTH CAROLINANORTH CAROLINA BOARD OF PROFESSIONAL COUNSELORS
35009986OTHERNORTH CAROLINANORTH CAROLINA LICENSE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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