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General NPI Number Information
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NPI Number | 1205581717
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Entity Type | Individual
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Provider Name | DEBORAH K BEYENNE
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Gender | Female
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 2594 LOGANVILLE HWY STE 101
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City | GRAYSON
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State | GA
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Zip | 30017-7848
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Country | US
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Telephone | 678-369-2790
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Fax |
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Provider Business Mailing Address
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Address Line | 1665 HATTERAS TRL
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City | GRAYSON
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State | GA
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Zip | 30017-2916
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Country | US
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Telephone | 733-319-5952
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2021106395
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-NP315041
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License Number State | GA
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