Provider Demographics
NPI:1740763697
Name:DEEL, GERALD ORBIA (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:ORBIA
Last Name:DEEL
Suffix:
Gender:M
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 587
Mailing Address - Street 2:
Mailing Address - City:INMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29349-0587
Mailing Address - Country:US
Mailing Address - Phone:864-472-4808
Mailing Address - Fax:864-472-6243
Practice Address - Street 1:2060 LYNN RD STE 12
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-4501
Practice Address - Country:US
Practice Address - Phone:864-472-4808
Practice Address - Fax:864-472-6243
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC223256163W00000X
SC22270363LA2200X
FL349363LA2200X
GAGAA-NP001034363LA2200X
NC5013694363LA2200X
SC54-22270363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP8344Medicaid
NC1740763697Medicaid
FL349OtherFLORIDA TELEHEALTH PROVIDER