Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Johnathan Donald Debetta

Individual provider Physician Assistant · NPI 1164003570

Johnathan Donald Debetta is a Physician Assistant in Lillington, North Carolina. Licensed in North Carolina. Registered with an NPI since 2021.

Licensed in
NC
In the registry since
2021

Practice location Address checks out

4350 US 421 S
Lillington, NC 27546-6760
Phone: (910) 893-1210
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-11534 (NC)

Record details

NPI number1164003570
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 16, 2021
Last updated in NPPESDecember 7, 2021
Certification dateDecember 7, 2021
Mailing address10118 Knotty Pine Ln, Raleigh, NC 27617-8218

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