Provider Demographics
NPI:1699981548
Name:DUMPHY, DEBORAH ANN (NP-C,APRN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANN
Last Name:DUMPHY
Suffix:
Gender:F
Credentials:NP-C,APRN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 DAWSON COMMONS CIRCLE
Mailing Address - Street 2:STE. 320
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534
Mailing Address - Country:US
Mailing Address - Phone:706-216-2770
Mailing Address - Fax:706-216-2944
Practice Address - Street 1:300 DAWSON COMMONS CIRCLE
Practice Address - Street 2:STE. 320
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534
Practice Address - Country:US
Practice Address - Phone:706-216-2770
Practice Address - Fax:706-216-2944
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2013-09-23
Deactivation Date:2009-01-13
Deactivation Code:
Reactivation Date:2010-08-09
Provider Licenses
StateLicense IDTaxonomies
GARN169649NP363LF0000X
GARN169649163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA313892279AMedicaid