Healthcare Provider Details

I. General information

NPI: 1821202243
Provider Name (Legal Business Name): DEBRA BURNETT NOWLIN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 CENTER ST
COLUMBUS GA
31901-1527
US

IV. Provider business mailing address

239 WOODFIELD DR
AUBURN AL
36830-5910
US

V. Phone/Fax

Practice location:
  • Phone: 706-571-1495
  • Fax: 706-571-1861
Mailing address:
  • Phone: 706-587-4790
  • Fax: 706-571-1861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10706
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14491
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: