Healthcare Provider Details

I. General information

NPI: 1619029725
Provider Name (Legal Business Name): DEBORAH SCHREER CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 10/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1761 MILFORD CREEK OVERLOOK SW
MARIETTA GA
30008-8110
US

IV. Provider business mailing address

PO BOX 92
MARIETTA GA
30061-0092
US

V. Phone/Fax

Practice location:
  • Phone: 404-509-4931
  • Fax: 404-509-4931
Mailing address:
  • Phone: 404-509-4931
  • Fax: 404-509-4931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN069889
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: