Healthcare Provider Details

I. General information

NPI: 1881137149
Provider Name (Legal Business Name): DEBORAH RAMONA RACADAG BSN, RN, CCHP-N
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH RAMONA MILLER BSN, RN, CCHP-N

II. Dates (important events)

Enumeration Date: 11/18/2016
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 HWY 441 SOUTH UNIT 2
CLAYTON GA
30525
US

IV. Provider business mailing address

621 HWY 441 SOUTH UNIT 2
CLAYTON GA
30525-0030
US

V. Phone/Fax

Practice location:
  • Phone: 706-613-4485
  • Fax: 762-212-4368
Mailing address:
  • Phone: 706-613-4485
  • Fax: 762-212-4368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN263751
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN263751
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: