Provider Demographics
NPI:1033817127
Name:MCINTOSH, DEBORAH A (CNA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 HAVERHILL CIR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-2081
Mailing Address - Country:US
Mailing Address - Phone:770-681-1819
Mailing Address - Fax:
Practice Address - Street 1:903 HAVERHILL CIR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-2081
Practice Address - Country:US
Practice Address - Phone:770-681-1819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030035292251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health