Provider Demographics
NPI:1780943332
Name:COLEMAN, DEBORAH A (RN)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W WALNUT AVE
Mailing Address - Street 2:SUITE 92
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-8402
Mailing Address - Country:US
Mailing Address - Phone:706-272-2712
Mailing Address - Fax:706-272-2266
Practice Address - Street 1:100 W WALNUT AVE
Practice Address - Street 2:SUITE 92
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-8402
Practice Address - Country:US
Practice Address - Phone:706-272-2712
Practice Address - Fax:706-272-2266
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN044412163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse