Provider Demographics
NPI:1083783021
Name:PIETRANGELO, DEBORAH COLLINS (FNPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:COLLINS
Last Name:PIETRANGELO
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:JEAN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNPC
Mailing Address - Street 1:101 RIVERSTONE VIS STE 215
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-6665
Mailing Address - Country:US
Mailing Address - Phone:706-946-4227
Mailing Address - Fax:706-258-4715
Practice Address - Street 1:101 RIVERSTONE VIS STE 215
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-6665
Practice Address - Country:US
Practice Address - Phone:706-946-4227
Practice Address - Fax:706-258-4715
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN181932363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2592778Medicare PIN