Provider Demographics
NPI:1497832406
Name:PICKETT, DEBORAH SUE (RN)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:SUE
Last Name:PICKETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:PICKETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:99 JESSE HILL JR DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:404-730-1200
Mailing Address - Fax:
Practice Address - Street 1:151 ELLIS ST NE
Practice Address - Street 2:SUITE 150
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-2420
Practice Address - Country:US
Practice Address - Phone:404-730-4018
Practice Address - Fax:404-730-8376
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN158940163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse