Provider Demographics
NPI:1881137149
Name:RACADAG, DEBORAH RAMONA (BSN-RN)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:RAMONA
Last Name:RACADAG
Suffix:
Gender:F
Credentials:BSN-RN
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:RAMONA
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN-RN
Mailing Address - Street 1:PO BOX 1170
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:GA
Mailing Address - Zip Code:30525-0030
Mailing Address - Country:US
Mailing Address - Phone:706-613-4485
Mailing Address - Fax:
Practice Address - Street 1:95 GOLDEN HILLS DRIVE
Practice Address - Street 2:SUITE D
Practice Address - City:MOUNTAIN CITY
Practice Address - State:GA
Practice Address - Zip Code:30562
Practice Address - Country:US
Practice Address - Phone:706-613-4485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-18
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN263751163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health