Healthcare Provider Details

I. General information

NPI: 1891834149
Provider Name (Legal Business Name): DEBORAH S YORK ARPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 03/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 PROFESSIONAL BLVD
DALTON GA
30720-2536
US

IV. Provider business mailing address

900 SANDY DUNES UNIT # 2
DALTON GA
30721
US

V. Phone/Fax

Practice location:
  • Phone: 706-226-5446
  • Fax: 706-278-3884
Mailing address:
  • Phone: 706-259-5077
  • Fax: 706-278-3884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN061087
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: