Provider Demographics
NPI:1972969160
Name:RATHBUN, DEBRA D (NP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:D
Last Name:RATHBUN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 LOBINGER AVE
Mailing Address - Street 2:
Mailing Address - City:FITZGERALD
Mailing Address - State:GA
Mailing Address - Zip Code:31750-8181
Mailing Address - Country:US
Mailing Address - Phone:229-425-3809
Mailing Address - Fax:
Practice Address - Street 1:1025 KIRKLAND LN
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-2043
Practice Address - Country:US
Practice Address - Phone:912-208-5680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN118146282NR1301X, 363LF0000X
GA118146363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No282NR1301XHospitalsGeneral Acute Care HospitalRural
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner