Provider Demographics
NPI:1598734758
Name:JONES, DEBORAH YVETTE (NP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:YVETTE
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:YVETTE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4045 MOUNT VERNON DRIVE
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189
Mailing Address - Country:US
Mailing Address - Phone:404-444-3463
Mailing Address - Fax:
Practice Address - Street 1:7545 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-1845
Practice Address - Country:US
Practice Address - Phone:770-928-0133
Practice Address - Fax:770-928-1663
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN092126363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000819849CMedicaid
GAP92404Medicare UPIN
GAP92404Medicare UPIN