Provider Demographics
NPI:1154309128
Name:BOYLE BORKOWSKI, DEBORA K (APRN BC MSN RN CNS)
Entity type:Individual
Prefix:MS
First Name:DEBORA
Middle Name:K
Last Name:BOYLE BORKOWSKI
Suffix:
Gender:F
Credentials:APRN BC MSN RN CNS
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT ROAD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-949-5019
Mailing Address - Fax:
Practice Address - Street 1:2400 MOUNT ZION PARKWAY
Practice Address - Street 2:DEPARTMENT OF BEHAVIORAL HEALTH
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236
Practice Address - Country:US
Practice Address - Phone:770-603-3649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN186440CNS/PMH163WP0807X
GARN186440364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
DES38699Medicare UPIN
DE00A901D23Medicare PIN