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Licensee Information

Derek Kelly Coburn - PA-C
0010-06199
Active
No
01/15/2016
01/14/2027

Active Supervisor

NameTypeStatusApprovedInactive
Bolden, Jason Edward, MD MD Active 02/25/2020
Jones, Lauren Natasha, MD MD Active 08/06/2020

North Carolina Hospital Admitting Privileges

Location
Atrium Health Mercy
Atrium Health SouthPark Emergency Department
Carolinas Medical Center Mercy/Pineville
Carolinas Medical Center University

Out of State Active/Inactive Licenses

State
South Carolina

Out of Country Active/Inactive Licenses

Country
None Reported
Information loaded from this database is current as of 5/10/2026 12:09:56 PM
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