MEDICARE: MRS. DEBORAH RUTH FLANSBURG CNM, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	197676-4402	UT

General Provider Information

NPI Number	:	1538231808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH RUTH FLANSBURG CNM, MS

Provider Business Mailing Address
First Line	:	PO BOX 743120
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-3120
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2380 N 400 E STE A
Second Line	:
City	:	NORTH LOGAN
State	:	UT
Zip	:	84341-1756
Country	:	US
Telephone Number	:	435-713-1300
Fax Number	:	435-713-1320

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	04/13/2020

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