Provider Demographics
NPI:1124195672
Name:ADAMS, DEBRA ANN (APRN)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S PATTERSON ST
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31601-5668
Mailing Address - Country:US
Mailing Address - Phone:229-333-5257
Mailing Address - Fax:229-245-2341
Practice Address - Street 1:206 S PATTERSON ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31601-5668
Practice Address - Country:US
Practice Address - Phone:229-333-5257
Practice Address - Fax:229-245-2341
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN050354363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000440195DMedicaid
GA000440195GMedicaid
GA000440195KMedicaid
GA000440195EMedicaid
GA000440195JMedicaid
GA000440195IMedicaid
GA000440195HMedicaid
GA000440195MMedicaid
GA000440195CMedicaid
GA000440195FMedicaid
GA000440195LMedicaid