Provider Demographics
NPI:1184793382
Name:SEALS, DEBORAH JEANICE (LPN)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:JEANICE
Last Name:SEALS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:JEANICE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5328
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906
Mailing Address - Country:US
Mailing Address - Phone:706-596-5557
Mailing Address - Fax:706-596-5539
Practice Address - Street 1:2100 CORNER AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904
Practice Address - Country:US
Practice Address - Phone:706-596-5557
Practice Address - Fax:706-596-5539
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN051709164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse